NPIMap

Organization Active NPI

Be Squared Nutrition LLC

  • Registered Dietitian
  • Charlottesville, VA
National Provider Identifier
1316637812
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
BE SQUARED NUTRITION LLC
Practice address
515 Park St Ste C
Charlottesville, VA 22902-4769
Phone
(434) 234-4591
Fax
(855) 955-3898
NPI assigned
May 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Ms. Bethany Blalock, RDNNPI 1699274811
Title
Owner
Phone
(434) 234-4591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary
Pediatric Nutrition Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133VN1004X

Addresses

Primary practice location

515 Park St Ste C
Charlottesville, VA 22902-4769

Mailing address

515 Park St Ste C
Charlottesville, VA 22902-4769
Phone (434) 234-4591

Other identifiers 1

IdentifierTypeStateIssuer
86012192OtherCOMMISSION ON DIETETIC REGISTRATION

National Provider Directory

National Provider Directory

Locations

515 Park St
Ste C
Charlottesville, VA 22902
Phone (434) 234-4591

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1316637812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PARK ST STE C",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024769",
            "telephone_number": "434-234-4591",
            "fax_number": "855-955-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PARK ST STE C",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024769",
            "telephone_number": "434-234-4591",
            "fax_number": "855-955-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BE SQUARED NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-234-4591",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86012192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.