Organization Active NPI

Nutrition Connection Group LLC

  • Nutritionist
  • Dearborn Heights, MI
National Provider Identifier
1417823006
Registry record updated Oct 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
NUTRITION CONNECTION GROUP LLC
Practice address
25150 Ford Rd Ste 200
Dearborn Heights, MI 48127-3163
Phone
(313) 284-0822
NPI assigned
Oct 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2025

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

Authorized official

Name
Mona FakihNPI 1003013913
Title
Owner
Phone
(313) 284-0822

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X Primary
DoulaGroup: 193200000X MULTI-SPECIALTY GROUP 374J00000X

Addresses

Primary practice location

25150 Ford Rd Ste 200
Dearborn Heights, MI 48127-3163

Mailing address

25150 Ford Rd Ste 200
Dearborn Heights, MI 48127-3163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251110001309 MI Part B Supplier - Clinic/Group Practice 5698265460 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn Heights, MI

National Provider Directory

National Provider Directory

Practitioners & 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": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761436800000",
    "number": "1417823006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25150 FORD RD STE 200",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25150 FORD RD STE 200",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273163",
            "telephone_number": "313-284-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION CONNECTION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A",
        "authorized_official_last_name": "FAKIH",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-284-0822"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2025; 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.

Verify at the official NPI Registry.