NPIMap

Organization Active NPI

Condren Family Nutrition

  • Registered Dietitian
  • Little Rock, AR
National Provider Identifier
1467122309
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
CONDREN FAMILY NUTRITION
Practice address
4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844
Phone
(501) 779-8327
Fax
(501) 500-5750
NPI assigned
Sep 13, 2021
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Agnes P. Condren, RD, LDNPI 1265899421
Title
Owner
Phone
(501) 779-8327

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844

Mailing address

4 Shackleford PLZ Ste 209
Little Rock, AR 72211-1844
Phone (501) 779-8327

Other names 2

  • Agnes Condren RD, LD Other name
  • Condren Family Nutrition Other name

National Provider Directory

National Provider Directory

Locations

10020 N Rodney Parham Rd
Ste F
Little Rock, AR 72227
Phone (501) 779-8327

4 Shackleford Plz
Ste 209
Little Rock, AR 72211
Phone (501) 777-8120

Practitioners & affiliated clinicians

Practitioners 7

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": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1467122309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLZ STE 209",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-779-8327",
            "fax_number": "501-500-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLZ STE 209",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-779-8327",
            "fax_number": "501-500-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONDREN FAMILY NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "CONDREN",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-779-8327",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agnes Condren RD, LD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Condren Family Nutrition",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.