NPIMap

Organization Active NPI

Nutrition Consultants of Atlanta, LLC

  • Registered Dietitian
  • Tucker, GA
National Provider Identifier
1598794604
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION CONSULTANTS OF ATLANTA, LLC
Practice address
1105 Chipwood Path
Tucker, GA 30084-1434
Phone
(404) 664-3219
Fax
(770) 723-1397
NPI assigned
Jul 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marisa Isabel Wynn, RD, LD
Title
Managing Partner
Phone
(678) 207-9139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1105 Chipwood Path
Tucker, GA 30084-1434

Mailing address

1105 Chipwood Path
Tucker, GA 30084-1434
Phone (404) 664-3219

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598794604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CHIPWOOD PATH",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300841434",
            "telephone_number": "404-664-3219",
            "fax_number": "770-723-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 CHIPWOOD PATH",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300841434",
            "telephone_number": "404-664-3219",
            "fax_number": "770-723-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION CONSULTANTS OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "MARISA",
        "authorized_official_middle_name": "ISABEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-207-9139",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.