Active NPI
Good Health Nutrition Services LLC
- Metabolic Nutrition Registered Dietitian
- Largo, MD
National Provider Identifier
1356825145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- Legal business name
- GOOD HEALTH NUTRITION SERVICES LLC
- Practice address
- 1300 Mercantile LN Ste 129-37
Largo, MD 20774-5327 - Phone
- (301) 341-4680
- Fax
- (301) 341-4680
- NPI assigned
- Sep 18, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Florence I Omerennah, RDLD/N
- Title
- Ceo/Owner
- Phone
- (240) 475-2966
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | Primary |
Addresses
Primary practice location
1300 Mercantile LN Ste 129-37
Largo, MD 20774-5327
Mailing address
210 Settlers Way
Upper Marlboro, MD 20774-5770
Phone (301) 341-4680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1300 Mercantile Ln
Ste 12937
Upper Marlboro, MD 20774
Phone (301) 341-4680
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": "1537228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701216000000",
"number": "1356825145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 SETTLERS WAY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207745770",
"telephone_number": "301-341-4680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 MERCANTILE LN STE 129-37",
"city": "LARGO",
"state": "MD",
"postal_code": "207745327",
"telephone_number": "301-341-4680",
"fax_number": "301-341-4680"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD HEALTH NUTRITION SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-18",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A",
"authorized_official_last_name": "OMERENNAH",
"authorized_official_first_name": "FLORENCE",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "240-475-2966",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RDLD/N"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.