Organization Active NPI

Keystone Nutrition

  • Nutritionist
  • Bryn Mawr, PA
National Provider Identifier
1518501055
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Legal business name
KEYSTONE NUTRITION
Practice address
21 Old Oaks Rd
Bryn Mawr, PA 19010-1024
Phone
(610) 324-9398
NPI assigned
Oct 28, 2019
Last updated
Apr 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OLD OAKS PROFESSIONAL SERVICES CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Ms. Melissa Wilson Twedt, MS, CNS, LDNNPI 1437628823
Title
Clinical Nutritionist
Phone
(610) 525-1422

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
Nutritionist 133N00000X NU Primary

Addresses

Primary practice location

21 Old Oaks Rd
Bryn Mawr, PA 19010-1024

Mailing address

512 W Lancaster Ave
Wayne, PA 19087-3122
Phone (610) 525-1422

National Provider Directory

National Provider Directory
Part of
Keystone Nutrition

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1518501055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W LANCASTER AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873122",
            "telephone_number": "610-525-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OLD OAKS RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101024",
            "telephone_number": "610-324-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE NUTRITION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLD OAKS PROFESSIONAL SERVICES CORP.",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "TWEDT",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "CLINICAL NUTRITIONIST",
        "authorized_official_telephone_number": "610-525-1422",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, CNS, LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.