Ajay Philip Koleth

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Practice address

220 W Elk Ave
Elizabethton, TN 37643-2612

Phone

(423) 561-1623

NPI assigned

May 19, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fit Clean Meals LLC

  • Home Delivered Meals
  • Elizabethton, TN
  • NPI 1437876604
  NPD Authorized official

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1477290484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432612",
            "telephone_number": "423-561-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432612",
            "telephone_number": "423-561-1623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Timothy Rd",
            "address_purpose": "LOCATION",
            "city": "Hilham",
            "state": "TN",
            "postal_code": "385686401",
            "country_code": "US",
            "telephone_number": "423-561-1623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLETH",
        "first_name": "AJAY",
        "middle_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celesta V Kirk, FNP
• James Kirkpatrick III, MD
• Chelsea Lynn Kiser, RN
• Tammy L Kitchens, M.D.
• Susan Lyasko Klugewicz, M.D.
• Kansas Jessee Krabbe, FNP-C
• Benjamin Krug, MS, OTR/L
• Sudha Raj Kumar, NURSE PRACTITIONER
• L & L Drug Company Inc
• Lea Lafluer, L.C.S.W.

• Nutrition Education Nutritionist in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Nutrition Education Nutritionist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.