Preferred Nutrition Services, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

PREFERRED NUTRITION SERVICES, LLC

Practice address

2380 3Rd St S
Jacksonville Beach, FL 32250-4072

Phone

(904) 270-1234

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Marilyn Dahl, RD, MBA,

Title

Principal

Phone

(904) 270-1234

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1346463221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504072",
            "telephone_number": "904-270-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504072",
            "telephone_number": "904-270-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED NUTRITION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "904-270-1234",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, MBA,"
    },
    "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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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.