Western Reserve Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

4344 Issued in OH

Legal business name

WESTERN RESERVE NUTRITION

Practice address

9205 State Route 43 Ste 106
Streetsboro, OH 44241-5366

Phone

(330) 554-9327

Fax

(330) 294-5651

NPI assigned

Nov 7, 2016

Last updated

Nov 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn Joseph Bouquot, RDNNPI 1922208198

Title

Owner

Phone

(330) 554-9327

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyn Joseph Bouquot, R.D., L.D.

  • Registered Dietitian
  • Streetsboro, OH
  • NPI 1922208198
  Authorized official Same address or phone

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1356883474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 BRADFORD WAY",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363901",
            "telephone_number": "330-554-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 STATE ROUTE 43 STE 106",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415366",
            "telephone_number": "330-554-9327",
            "fax_number": "330-294-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN RESERVE NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "BOUQUOT",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-554-9327",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "4344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesseca Marie Wallace
• Kuei-Mei Wang, NP
• Curtis Evan Webster
• Wellstreet of Georgia PC
• Western Reserve Eye Associates, Inc. (ClearVision Centers)
• Gary L Wheat, DC
• Kelley Wheatley
• Paula Elizabeth Williams, L.M.T
• Vaishali Williams, RN
• Alexandria A Willis

• Registered Dietitian in Streetsboro, OH
• Providers in Streetsboro, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.