Organization Active NPI

Option 1 Nutrition Solutions LLC

Doing business as Aveanna Healthcare Medical Solutions

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Denver, CO
National Provider Identifier
1548347156
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
OPTION 1 NUTRITION SOLUTIONS LLC
Doing business as
Aveanna Healthcare Medical Solutions
Practice address
4990 Nome St
Suite B
Denver, CO 80239-2735
Phone
(720) 529-8323
Fax
(720) 529-5748
NPI assigned
Nov 1, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Primary

Addresses

Primary practice location

4990 Nome St
Suite B
Denver, CO 80239-2735

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other identifiers 1

IdentifierTypeStateIssuer
61224375MedicaidCO

Other names 1

  • Aveanna Healthcare Medical Solutions Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930028712 CO DME Supplier - Medical Supply Company 8325250251 Practice locations: Denver, CO

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Aveanna Healthcare Medical Solution4990 Nome St, Denver, CO 80239-2736(866) 883-1188 Enteral Nutrients|Enteral Equipment and/or Supplies Does not accept assignmentParticipating since Oct 22, 2001

National Provider Directory

National Provider Directory
Tax ID family
Option 1 Nutrition Solutions LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1548347156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 NOME ST",
            "address_2": "SUITE B",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802392735",
            "telephone_number": "720-529-8323",
            "fax_number": "720-529-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTION 1 NUTRITION SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61224375",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare Medical Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.