Root Deep Nutrition and Wellness

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

ROOT DEEP NUTRITION AND WELLNESS

Practice address

646 Main St
Port Jefferson, NY 11777-2235

Phone

(631) 560-4466

NPI assigned

Feb 15, 2024

Organization subpart

No

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

Authorized official

Name

Anne Marie Berggren, RDNNPI 1992184956

Title

Owner

Phone

(631) 560-4466

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.

• Anne Marie Berggren, RDN, CNSC

  • Registered Dietitian
  • Port Jefferson Station, NY
  • NPI 1992184956

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1619732914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CLEMATIS ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761802",
            "telephone_number": "163-156-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772235",
            "telephone_number": "631-560-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT DEEP NUTRITION AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "BERGGREN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-560-4466",
        "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": []
}

• Denise Rohde, P.A.
• Rebecca Rohman, LMSW
• Alyssa Romano, LMSW
• Christine Romano
• Rosario J Romano, MD
• Janiece Loren Rosado
• Linda S Rosasco, LCSW
• Deborah Rose-Adams
• Nancy Rosenberg, LCSW
• Ella Rosenbloom, M.D.

• Registered Dietitian in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.