NPIMap

Organization Active NPI

Red Mountain Dietitian Services LLC

Doing business as Red Mountain Nutrition

  • Registered Dietitian
  • Mesa, AZ
National Provider Identifier
1578327110
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
RED MOUNTAIN DIETITIAN SERVICES LLC
Doing business as
Red Mountain Nutrition
Practice address
2929 N Power Rd
Mesa, AZ 85215-1745
Phone
(480) 266-4122
Fax
(480) 563-6950
NPI assigned
Feb 13, 2024
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Tina Alexander, RDNNPI 1679997084
Title
Owner
Phone
(480) 266-4122

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary
Diabetes Educator Registered Nurse 163WD0400X
Health Educator 174H00000X
Health & Wellness Coach 171400000X

Addresses

Primary practice location

2929 N Power Rd
Mesa, AZ 85215-1745

Mailing address

2929 N Power Rd
Mesa, AZ 85215-1745
Phone (480) 266-4122

Other names 1

  • Red Mountain Nutrition Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240402003859 AZ MDPP Supplier - in-Person MDPP Supplier 8224370457 1 other NPI on this enrollment
Practice locations: Mesa, AZ

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2373 E Baseline Rd
Ste 102
Gilbert, AZ 85234
Phone (480) 266-4122

2929 N Power Rd
Mesa, AZ 85215
Phone (480) 266-4122

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1578327110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 N POWER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151745",
            "telephone_number": "480-266-4122",
            "fax_number": "480-563-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 N POWER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151745",
            "telephone_number": "480-266-4122",
            "fax_number": "480-563-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN DIETITIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-266-4122",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Mountain Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.