NPIMap

Organization Active NPI

Fundamental Nutrition & Wellness, LLC.

  • Registered Dietitian
  • Lincoln, NE
National Provider Identifier
1497121313
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1110 Issued in NE
Legal business name
FUNDAMENTAL NUTRITION & WELLNESS, LLC.
Practice address
2690 W Sumner St
Lincoln, NE 68522-4439
Phone
(402) 202-6392
NPI assigned
Aug 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Authorized official

Name
Nathan L Lore, MS, RD, LD, LMNTNPI 1912399429
Title
Owner
Phone
(402) 202-6392

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 1110 NE Primary

Addresses

Primary practice location

2690 W Sumner St
Lincoln, NE 68522-4439

Mailing address

2690 W Sumner St
Lincoln, NE 68522-4439
Phone (402) 202-6392

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.

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1497121313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 W SUMNER ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224439",
            "telephone_number": "402-202-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 W SUMNER ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224439",
            "telephone_number": "402-202-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL NUTRITION & WELLNESS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "LORE",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-202-6392",
        "authorized_official_credential": "MS, RD, LD, LMNT"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "1110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.