Organization Active NPI

Youth Determined to Succeed

  • Nutrition Education Nutritionist
  • Minneapolis, MN
National Provider Identifier
1538403365
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Legal business name
YOUTH DETERMINED TO SUCCEED
Practice address
3333 N 4TH St
Minneapolis, MN 55412-2615
Phone
(612) 486-6720
NPI assigned
Nov 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Melvin Anderson
Title
Executive Officer
Phone
(612) 486-6730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X Primary

Addresses

Primary practice location

3333 N 4TH St
Minneapolis, MN 55412-2615

Mailing address

3333 N 4TH St
Minneapolis, MN 55412-2615

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1538403365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N 4TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N 4TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122615",
            "telephone_number": "612-486-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DETERMINED TO SUCCEED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "612-486-6730"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.