Mountain Home Nutrition Services LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-039 Issued in ID

Legal business name

MOUNTAIN HOME NUTRITION SERVICES LLC

Practice address

285 E 4TH N
Mountain Home, ID 83647

Phone

(208) 590-0858

NPI assigned

Jun 25, 2018

Last updated

Sep 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura J Moulton, RD,LDNPI 1558861831

Title

Owner

Phone

(208) 590-9348

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Laura Jean Moulton, R.D.N.

  • Registered Dietitian
  • Mountain Home, ID
  • NPI 1558861831
  Authorized official Same address or phone

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1417442120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 E 4TH N",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472716",
            "telephone_number": "208-590-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 E 4TH N",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83647",
            "telephone_number": "208-590-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME NUTRITION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "MOULTON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-590-9348",
        "authorized_official_credential": "RD,LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Monasterio, LPC
• Laura Jean Moulton, R.D.N.
• Mountain Gem Counseling, LLC
• Mountain Home Behavioral Health LLC
• Mountain Home Dental PC
• Mountain Home Physical Therapy, PC
• Mountain Home School District 193
• Timothy James Muhonen, MD
• Vernon T Mullins, MSN, APRN, FNP-BC
• Maria Buena Musacchio

• Registered Dietitian in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.