Organization Active NPI

Newmark Nutrition, LLC

  • Metabolic Nutrition Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1518318922
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
NEWMARK NUTRITION, LLC
Practice address
202 E Earll Dr Ste 425
Phoenix, AZ 85012-2649
Phone
(602) 264-3587
NPI assigned
Jun 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Jayne Newmark, RDNPI 1447641600
Title
Owner
Phone
(602) 264-3587

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
Metabolic Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133VN1006X Primary

Addresses

Primary practice location

202 E Earll Dr Ste 425
Phoenix, AZ 85012-2649

Mailing address

5182 W Vista Ave
Glendale, AZ 85301-8610
Phone (602) 264-3587

Other practice location 1

5182 W Vista Ave
Glendale, AZ 85301-8610
Phone (602) 264-3587

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160830002594 AZ Part B Supplier - Clinic/Group Practice 2567758550 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

202 E Earll Dr
Ste 425
Phoenix, AZ 85012
Phone (602) 264-3587

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": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1518318922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5182 W VISTA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853018610",
            "telephone_number": "602-264-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122649",
            "telephone_number": "602-264-3587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5182 W Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853018610",
            "country_code": "US",
            "telephone_number": "602-264-3587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEWMARK NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "NEWMARK",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-264-3587",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.