Pure Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD003274 Issued in GA

Legal business name

PURE NUTRITION LLC

Practice address

1 Legacy Dr
Roswell, GA 30075-6235

Phone

(678) 466-7025

Fax

(678) 466-7025

NPI assigned

Aug 30, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Natalie Flolo, RD, LD, CDE

Title

Owner

Phone

(678) 466-7025

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426291200000",
    "number": "1609182591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LEGACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756235",
            "telephone_number": "678-466-7025",
            "fax_number": "678-466-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LEGACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300756235",
            "telephone_number": "678-466-7025",
            "fax_number": "678-466-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2015-03-14",
        "status": "A",
        "authorized_official_last_name": "FLOLO",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-466-7025",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, LD, CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Publix Super Markets Inc (Publix Pharmacy #1043)
• Publix Super Markets, Inc. (Publix Pharmacy #0825)
• Brinthan Puhalrajan, NP-C
• Kailey Cameron Pullen, OTR
• Anagha Vaibhav Punyarthi, OT
• Flynn Ann Pustilnik, LPC, NCC
• Ellen Pye, PT, DPT
• Anila Qidwai, MD
• Michael Ian Quackenbush, D.O.
• Thomas W Query, LPC

• Registered Dietitian in Roswell, GA
• Providers in Roswell, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; 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.