Medical Nutritional Therapists, Inc

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MEDICAL NUTRITIONAL THERAPISTS, INC

Practice address

4210 Flagstaff CV
Fort Wayne, IN 46815-4417

Phone

(260) 489-9009

Fax

(260) 489-5057

NPI assigned

Jun 11, 2006

Last updated

Jul 21, 2022By 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

Mr. James A Holb, RD,LD,CDENPI 1740217819

Title

Vice President/Owner

Phone

(260) 489-9009

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Medical Nutritional Therapists Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Medical Nutritional Therapists, Inc.

  • Metabolic Nutrition Registered Dietitian
  • Louisville, KY
  • NPI 1891801791
  NPD tax ID
• Medical Nutritional Therapists, Inc.

  • Registered Dietitian
  • Dublin, OH
  • NPI 1972545507
  NPD tax ID

Locations

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.

• James A Holb, RD,LD,CDE

  • Renal Nutrition Registered Dietitian
  • Fort Wayne, IN
  • NPI 1740217819
  Authorized official Same address or phone

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1619919263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 FLAGSTAFF CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154417",
            "telephone_number": "260-489-9009",
            "fax_number": "260-489-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 FLAGSTAFF CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154417",
            "telephone_number": "260-489-9009",
            "fax_number": "260-489-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL NUTRITIONAL THERAPISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HOLB",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT/OWNER",
        "authorized_official_telephone_number": "260-489-9009",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RD,LD,CDE"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2465612",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MDS Counseling Services, LLC
• Megan Rose Meador, LPN
• Medical Group of Fort Wayne, P.C. (The Heart Center of Fort Wayne)
• Medical Mobility Inc
• Medical Mobility, LLC
• Medical Service Company (MSC Sleep Fort Wayne)
• Melissa Marlene Medlock, O.D.
• Autumn Brooke Meece, LAT, ATC
• Thomas J Meehan
• Spencer D Meeks, AGPCNP-BC

• Registered Dietitian in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.