Team Acg LLC

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

ND3586 Issued in FL

Legal business name

TEAM ACG LLC

Practice address

3190 Suntree Blvd Ste 101
Rockledge, FL 32955-5741

Phone

(321) 255-7841

Fax

(888) 972-3871

NPI assigned

May 12, 2017

Organization subpart

No

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

Authorized official

Name

Angela Michelle Gallagher, RDN, LDN

Title

Registered Dietitian, Member

Phone

(321) 255-7841

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1558898296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 INDIGO CROSSING DR",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556053",
            "telephone_number": "321-255-7841",
            "fax_number": "888-972-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 SUNTREE BLVD STE 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329555741",
            "telephone_number": "321-255-7841",
            "fax_number": "888-972-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM ACG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN, MEMBER",
        "authorized_official_telephone_number": "321-255-7841",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "FL",
            "license": "ND3586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Metabolic Nutrition Registered Dietitian in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Metabolic Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.