Organization Active NPI

Nutra-Sense LLC

  • Registered Dietitian
  • Roseburg, OR
National Provider Identifier
1578325205
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRA-SENSE LLC
Practice address
1813 W Harvard Ave Ste 438
Roseburg, OR 97471-8705
Phone
(541) 900-6989
NPI assigned
Jan 29, 2024
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Shelli WillmanNPI 1467985515
Title
Owner
Phone
(541) 315-6957

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1813 W Harvard Ave Ste 438
Roseburg, OR 97471-8705

Mailing address

4410 Ridenour St
Roseburg, OR 97470-1004
Phone (541) 900-6989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240620002476 OR Part B Supplier - Clinic/Group Practice 4082157813 Receives reassigned benefits from 1 practitioner
Practice locations: Roseburg, OR

National Provider Directory

National Provider Directory

Locations

865 SE Court Ave
Ste 4
Roseburg, OR 97470

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1578325205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 RIDENOUR ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701004",
            "telephone_number": "541-900-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE STE 438",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718705",
            "telephone_number": "541-900-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRA-SENSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "WILLMAN",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-315-6957"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.