NPIMap

Organization Active NPI

Gut Brain Body

  • Nutritionist
  • San Diego, CA
National Provider Identifier
1447985320
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
GUT BRAIN BODY
Practice address
2048 Oliver Ave Apt a
San Diego, CA 92109-5568
Phone
(302) 897-2621
Fax
(302) 274-0071
NPI assigned
Jul 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Thomas PratherNPI 1972102317
Title
Owner
Phone
(302) 897-2621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X Primary

Addresses

Primary practice location

2048 Oliver Ave Apt a
San Diego, CA 92109-5568

Mailing address

2048 Oliver Ave Apt a
San Diego, CA 92109-5568
Phone (302) 897-2621

Other names 1

  • Max You Wellness Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tommy@gutbrainbody.com

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1658534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1447985320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 OLIVER AVE APT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095568",
            "telephone_number": "302-897-2621",
            "fax_number": "302-274-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 OLIVER AVE APT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095568",
            "telephone_number": "302-897-2621",
            "fax_number": "302-274-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUT BRAIN BODY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-23",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "PRATHER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-897-2621"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tommy@gutbrainbody.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2048 Oliver Ave Apt A",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921095568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Max You Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.