Nutrition Factory, LLC
Organization Active NPI Registered Dietitian · North Andover, MA
NPI 1366718355 · NPPES record last updated May 28, 2024
Key facts
- NPI
- 1366718355
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 133V00000X
- Legal business name
- NUTRITION FACTORY, LLC
- Practice address
- 565 Turnpike St Ste 64
North Andover, MA 01845-5936 - Phone
- (978) 474-4478
- Fax
- (978) 427-6229
- NPI assigned
- Mar 24, 2012
- Organization subpart
- No
Authorized official
- Name
- Shelley Ann Woolsey, RD
- Title
- Co Owner
- Phone
- (978) 474-4478
Practitioners 6
-
Shelley Ann Woolsey, RD, LDN
-
Hillary Monroe Mamis, RD, LDN
-
June Skuza, MED, RD,LDN
-
Elizabeth R Berman, RDN, LDN
-
Rhys Wyman, MS, RD, LDN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120830000029 | MA | Part B Supplier - Clinic/Group Practice | 8729235502 |
Receives reassigned benefits from 4 practitioners Practice locations: North Andover, MA |
National Provider Directory
Locations
68 Main St
Ste 3
Andover, MA 01810
Phone (978) 474-4478
282 Farmers Row
Groton, MA 01450
Phone (978) 448-3363
565 Turnpike St
Ste 64
North Andover, MA 01845
Phone (978) 474-4478
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | MA | Yes |
Addresses
Primary practice location
565 Turnpike St Ste 64
North Andover, MA 01845-5936
Mailing address
565 Turnpike St Ste 64
North Andover, MA 01845-5936
Phone (978) 474-4478
NPI Registry JSON
{
"created_epoch": "1332547200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716854400000",
"number": "1366718355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "565 TURNPIKE ST STE 64",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018455936",
"telephone_number": "978-474-4478",
"fax_number": "978-427-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 TURNPIKE ST STE 64",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018455936",
"telephone_number": "978-474-4478",
"fax_number": "978-427-6229"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NUTRITION FACTORY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-24",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A",
"authorized_official_last_name": "WOOLSEY",
"authorized_official_first_name": "SHELLEY",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "CO OWNER",
"authorized_official_telephone_number": "978-474-4478",
"authorized_official_credential": "RD"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
- Timothy J Norton
- Novamind DBT, LLC
- Millie Nunez
- Starlina Nunez
- Nursing & Retirement Center of Andovers, Inc.
- James Nyoike
- Claire Louise O'Brien
- Erin Mary O'Brien
- Jake O'Connell
- Erin M O'Connor
All providers in North Andover, MA · Registered Dietitian in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.