Wholistic Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

WHOLISTIC NUTRITION LLC

Practice address

3849 Silsby CT
Avon, OH 44011-3476

Phone

(419) 722-5016

NPI assigned

Sep 22, 2021

Organization subpart

No

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

Authorized official

Name

Alicia Basen, RD, LD

Title

Owner, Registered Dietitian

Phone

(419) 722-5016

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1407527229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3849 SILSBY CT",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440113476",
            "telephone_number": "419-722-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3849 SILSBY CT",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440113476",
            "telephone_number": "419-722-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTIC NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "BASEN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "419-722-5016",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "address_1": "3849 Silsby Ct",
            "city": "Avon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440113476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.