Purely Rooted Nutrition and Wellness

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

PURELY ROOTED NUTRITION AND WELLNESS

Practice address

850 Galen Dr
State College, PA 16803-1164

Phone

(814) 777-8919

NPI assigned

Feb 16, 2021

Organization subpart

No

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

Authorized official

Name

Mary Kathryn Gowdy, MS, CNS, LDN, CHHPNPI 1912590449

Title

Clinical Nutritionist

Phone

(814) 777-8919

Specialties & licenses 2

Addresses

Other names 1

• Purely Rooted Nutrition and Wellness Other name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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.

• Mary Kathryn Gowdy, MS, CNS, LDN, CHHP

  • Nutritionist
  • State College, PA
  • NPI 1912590449
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1528651064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 GALEN DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031164",
            "telephone_number": "814-777-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 GALEN DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031164",
            "telephone_number": "814-777-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURELY ROOTED NUTRITION AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "GOWDY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "CLINICAL NUTRITIONIST",
        "authorized_official_telephone_number": "814-777-8919",
        "authorized_official_credential": "MS, CNS, LDN, CHHP"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Purely Rooted Nutrition and Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Nutrition Education Nutritionist in State College, PA
• Providers in State College, PA by specialty
• Nutrition Education Nutritionist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.