Reformed Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

REFORMED NUTRITION LLC

Practice address

220 Albany Turnpike
Unit 1
Canton, CT 06019

Phone

(860) 299-6000

NPI assigned

Nov 21, 2019

Organization subpart

No

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

Authorized official

Name

Hunter Bahre, RDNPI 1710459227

Title

Owner

Phone

(860) 299-6000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hunter Bahre, RD

  • Registered Dietitian
  • Canton, CT
  • NPI 1710459227
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1629614953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN ST STE 276",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060323623",
            "telephone_number": "860-299-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ALBANY TURNPIKE",
            "address_2": "UNIT 1",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "06019",
            "telephone_number": "860-299-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFORMED NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "BAHRE",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-299-6000",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Canton, CT
• Providers in Canton, CT by specialty
• Registered Dietitian in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.