NPIMap

Organization Active NPI

Medical Nutrition Specialists LLC

  • Registered Dietitian
  • Brighton, CO
National Provider Identifier
1356977854
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MEDICAL NUTRITION SPECIALISTS LLC
Practice address
144 N 8TH Ave
Brighton, CO 80601-1728
Phone
(720) 447-1650
NPI assigned
Mar 16, 2020
Last updated
Mar 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Authorized official

Name
Derek Mercer
Title
Credentialing Executive
Phone
(720) 447-1650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

144 N 8TH Ave
Brighton, CO 80601-1728

Mailing address

144 N 8TH Ave
Brighton, CO 80601-1728

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1356977854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N 8TH AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806011728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 N 8TH AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806011728",
            "telephone_number": "720-447-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL NUTRITION SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CREDENTIALING EXECUTIVE",
        "authorized_official_telephone_number": "720-447-1650"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.