Open Concept Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

OPEN CONCEPT NUTRITION LLC

Practice address

W2713 730TH Ave
Spring Valley, WI 54767-8512

Phone

(715) 308-3895

NPI assigned

Jun 8, 2021

Last updated

Jun 8, 2021By 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

Charlotte Ruth Nellessen, RDNNPI 1861904534

Title

Sole Member

Phone

(715) 308-3895

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Charlotte Ruth Nellessen, RDN

  • Registered Dietitian
  • Eau Claire, WI
  • NPI 1861904534

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1457928467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2713 730TH AVE",
            "city": "SPRING VALLEY",
            "state": "WI",
            "postal_code": "547678512",
            "telephone_number": "715-308-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2713 730TH AVE",
            "city": "SPRING VALLEY",
            "state": "WI",
            "postal_code": "547678512",
            "telephone_number": "715-308-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN CONCEPT NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "NELLESSEN",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "715-308-3895",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861904534",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Marie Hague, LPN
• Kelly Jo Kopacz, RN
• Gary Bryan Lukes, OD
• Staci Elizabeth Maves, RN
• Midwest Physical Therapy
• Jack L Palumbo, D.D.S.
• Surbhi Pradeep Pimpalapure
• Refuge Farms, Inc.
• Allison Elizabeth Retzloff, RN
• Amy G Rohl

• Registered Dietitian in Spring Valley, WI
• Providers in Spring Valley, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.