Organization Active NPI

Homegrown Nutrition

  • Registered Dietitian
  • Honolulu, HI
National Provider Identifier
1497454201
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
HOMEGROWN NUTRITION
Practice address
820 W Hind Dr Unit 240343
Honolulu, HI 96824-1813
Phone
(484) 626-0758
Fax
(484) 379-0069
NPI assigned
Mar 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Maria Lynn Emerick, MS, RDN, LDNPI 1457092827
Title
Registered Dietitian
Phone
(484) 626-0758

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

820 W Hind Dr Unit 240343
Honolulu, HI 96824-1813

Mailing address

820 W Hind Dr Unit 240343
Honolulu, HI 96824-1813
Phone (484) 626-0758

Other practice location 1

2528 Ivan St
Bethlehem, PA 18020-4360
Phone (484) 626-0758

Other identifiers 1

IdentifierTypeStateIssuer
1457092827OtherPADIETITIAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240627001325 HI Part B Supplier - Clinic/Group Practice 5193184166 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI

National Provider Directory

National Provider Directory

Locations

820 W Hind Dr
Unit 240343
Honolulu, HI 96824
Phone (484) 626-0758

3232 Easton Ave
Unit 3186
Bethlehem, PA 18017

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": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1497454201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W HIND DR UNIT 240343",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968241813",
            "telephone_number": "484-626-0758",
            "fax_number": "484-379-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W HIND DR UNIT 240343",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968241813",
            "telephone_number": "484-626-0758",
            "fax_number": "484-379-0069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2528 Ivan St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180204360",
            "country_code": "US",
            "telephone_number": "484-626-0758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOMEGROWN NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "EMERICK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "484-626-0758",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIAN",
            "identifier": "1457092827",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.