Kbradley Whole Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

01013588 Issued in NJ

Legal business name

KBRADLEY WHOLE NUTRITION LLC

Practice address

437 Andre HL
Northvale, NJ 07647-1300

Phone

(201) 768-4629

NPI assigned

May 31, 2013

Last updated

May 31, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kristen Jill Bradley, RDNPI 1083980460

Title

President

Phone

(917) 578-5079

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristen Jill Bradley, R.D.

  • Registered Dietitian
  • Northvale, NJ
  • NPI 1083980460

  Dietitian, Registered

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1285071167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 ANDRE HL",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076471300",
            "telephone_number": "201-768-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 ANDRE HL",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076471300",
            "telephone_number": "201-768-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KBRADLEY WHOLE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-578-5079",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "01013588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Northvale, NJ
• Providers in Northvale, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.