Performance Edge Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

PERFORMANCE EDGE NUTRITION LLC

Practice address

1942 Broadway Ste 314C
Boulder, CO 80302-5233

Phone

(401) 829-1593

NPI assigned

Oct 31, 2023

Last updated

Feb 3, 2025By 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

Colby Wolf, MS, RDN, CSCSNPI 1629688924

Title

Performance Dietitian

Phone

(401) 829-1593

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.

• Colby Wolf, MS, RDN, CSCS

  • Sports Dietetics Nutrition Registered Dietitian
  • Boulder, CO
  • NPI 1629688924
  NPD Authorized official

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1447023601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 W 73RD PL",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800033124",
            "telephone_number": "401-829-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "401-829-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE EDGE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "COLBY",
        "authorized_official_title_or_position": "PERFORMANCE DIETITIAN",
        "authorized_official_telephone_number": "401-829-1593",
        "authorized_official_credential": "MS, RDN, CSCS"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Laci Perea
• Tomy Yojan Perez, M.D.
• Perfect Teeth - Folsom P.C.
• Perfect Teeth Boulder P.C.
• Performance Dental Center PLLC
• Shawn Perkin, LPC
• Douglas William Perkins, PT, DPT
• Robert David Perkins
• Michael J Perlman
• Tina M Pernosky

• Registered Dietitian in Boulder, CO
• Providers in Boulder, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.