Southern Nutrition Services, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SOUTHERN NUTRITION SERVICES, LLC

Practice address

406 Briarwood Dr Ste 402
Jackson, MS 39206-3063

Phone

(601) 691-4857

NPI assigned

Feb 4, 2026

Organization subpart

No

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

Authorized official

Name

Kyskie Bolton, RDNNPI 1396987376

Title

Director

Phone

(601) 691-4857

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.

• Kyskie Bolton, RD

  • Registered Dietitian
  • Madison, MS
  • NPI 1396987376

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1295686616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 BRIARWOOD DR STE 402",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063063",
            "telephone_number": "601-691-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BRIARWOOD DR STE 402",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063063",
            "telephone_number": "601-691-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN NUTRITION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "KYSKIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-691-4857",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Stephen Southern, EDD
• Tracy Southern

• Registered Dietitian in Jackson, MS
• Providers in Jackson, MS by specialty
• Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.