Ellen J Matheson Functional Wellness Solutions, LLC

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

ELLEN J MATHESON FUNCTIONAL WELLNESS SOLUTIONS, LLC

Practice address

621 Wappoo Rd
Seed of Life Collective
Charleston, SC 29407-1800

Phone

(843) 410-8567

NPI assigned

Sep 8, 2016

Organization subpart

No

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

Authorized official

Name

Ellen J Matheson, MS, CNS, LMTNPI 1891242772

Title

Certified Nutrition Specialist

Phone

(843) 410-8567

Specialties & licenses 2

Addresses

Other names 1

• eljema wellness Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellen J Matheson, MS, CNS, LMT

  • Nutritionist
  • Charleston, SC
  • NPI 1891242772
  NPD (past) Authorized official

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1417404302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 CATHEDRAL LN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147309",
            "telephone_number": "843-324-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 WAPPOO RD",
            "address_2": "SEED OF LIFE COLLECTIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294071800",
            "telephone_number": "843-410-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN J MATHESON FUNCTIONAL WELLNESS SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "MATHESON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CERTIFIED NUTRITION SPECIALIST",
        "authorized_official_telephone_number": "843-410-8567",
        "authorized_official_credential": "MS, CNS, LMT"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eljema wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elite Performance Concepts, LLC
• Elizabeth J. Dixon, LLC
• Jennifer L Elkins, BCBA
• Chloe Denae Elledge
• Jonathan Ellement, M.D.
• Allison Elliott
• Bruce Elliott, MD
• James D Elliott III, O.D.
• Jean Marie Elliott, M.ED., LPC, NCC, RPT
• Laurie A Elliott, M.D.

• Nutrition Education Nutritionist in Charleston, SC
• Providers in Charleston, SC by specialty
• Nutrition Education Nutritionist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.