Nepa Nutrition and Personal Training Service LLC.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN004885 Issued in PA

Legal business name

NEPA NUTRITION AND PERSONAL TRAINING SERVICE LLC.

Practice address

414 E Drinker St
Suite 102
Dunmore, PA 18512-2469

Phone

(570) 207-7846

Fax

(570) 207-2788

NPI assigned

May 29, 2014

Last updated

Jun 17, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stefanie Smith, MS RDN LDN

Title

Owner

Phone

(570) 687-8230

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1568874113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E DRINKER ST",
            "address_2": "SUITE 102",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185122469",
            "telephone_number": "570-207-7846",
            "fax_number": "570-207-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E DRINKER ST",
            "address_2": "SUITE 102",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185122469",
            "telephone_number": "570-207-7846",
            "fax_number": "570-207-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPA NUTRITION AND PERSONAL TRAINING SERVICE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-687-8230",
        "authorized_official_credential": "MS RDN LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Dunmore, PA
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• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.