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Organization Active NPI

Southern Illinois Nutrition Specialties

  • Registered Dietitian
  • Carbondale, IL
National Provider Identifier
1487700696
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SOUTHERN ILLINOIS NUTRITION SPECIALTIES
Practice address
1350 Cedar CT
Carbondale, IL 62901-5336
Phone
(618) 942-7300
NPI assigned
Jan 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lori Trentacosti, R.D.
Title
Owner
Phone
(618) 942-7300

Specialties & licenses 1

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

Addresses

Primary practice location

1350 Cedar CT
Carbondale, IL 62901-5336

Mailing address

PO Box 3301
Carbondale, IL 62902-3301
Phone (618) 942-7300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487700696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3301",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023301",
            "telephone_number": "618-942-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015336",
            "telephone_number": "618-942-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS NUTRITION SPECIALTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRENTACOSTI",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-942-7300",
        "authorized_official_credential": "R.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.