Gymboom LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

GYMBOOM LLC

Practice address

3250 W 66TH St Apt 548
Edina, MN 55435-5514

Phone

(320) 309-8913

NPI assigned

Dec 29, 2021

Last updated

Dec 29, 2021By 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

Emma Marie Backes, RDNNPI 1184237919

Title

Provider

Phone

(320) 309-8913

Specialties & licenses 1

Addresses

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.

• Emma M Backes, RDN

  • Registered Dietitian
  • Saint Cloud, MN
  • NPI 1184237919
  Authorized official Same address or phone

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1598425761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W 66TH ST APT 548",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355514",
            "telephone_number": "320-309-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W 66TH ST APT 548",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355514",
            "telephone_number": "320-309-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYMBOOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "BACKES",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "320-309-8913",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlyne Jeane Gutmann, PH.D., L.P.,B.C.B.A.
• Mark Guyott
• Robin M Gwaltney, M.D.
• Tenzin Gyalmo, LICSW, MSW
• Bernice Gyamfi, APRN, CNP
• Caroline Picone Haakenson, M.D.
• Frederick J Haas, D.D.S.
• Rachel Haas
• Sherri Haas, DO
• Tonya Lynn Haase, RN, CNP

• Registered Dietitian in Edina, MN
• Providers in Edina, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.