Active NPI
Bethanyrd Nutrition LLC
- Registered Dietitian
- Minnetonka, MN
National Provider Identifier
1407598634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- BETHANYRD NUTRITION LLC
- Practice address
- 5625 Vine Hill Rd
Minnetonka, MN 55345-5038 - Phone
- (218) 213-6472
- NPI assigned
- Apr 8, 2022
- 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
- Bethany Motley
- Title
- Owner
- Phone
- (218) 213-6472
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
5625 Vine Hill Rd
Minnetonka, MN 55345-5038
Mailing address
5625 Vine Hill Rd
Minnetonka, MN 55345-5038
Phone (218) 213-6472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & 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": "1649376000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649376000000",
"number": "1407598634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5625 VINE HILL RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553455038",
"telephone_number": "218-213-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5625 VINE HILL RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553455038",
"telephone_number": "218-213-6472"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BETHANYRD NUTRITION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A",
"authorized_official_last_name": "MOTLEY",
"authorized_official_first_name": "BETHANY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "218-213-6472"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.