Active NPI
Agnieszka Spuzak
- Nutritionist
- Boulder, CO
National Provider Identifier
1316489396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NAP16053
- Practice address
- 1267 Fourmile Canyon Dr
Boulder, CO 80302 - Phone
- (720) 442-1081
- NPI assigned
- Nov 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NAP16053 | CO | Primary |
Addresses
Primary practice location
1267 Fourmile Canyon Dr
Boulder, CO 80302
Mailing address
1267 Four Mile Canyon Dr
Boulder, CO 80302
Phone (720) 442-1081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NAP16053 | CO | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1316489396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1267 FOUR MILE CANYON DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-442-1081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1267 FOURMILE CANYON DR",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-442-1081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPUZAK",
"first_name": "AGNIESZKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-08",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "CO",
"license": "NAP16053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.