Organization Active NPI

Balanced Living Nutrition LLC

  • Registered Dietitian
  • Clearwater, FL
National Provider Identifier
1629948567
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
BALANCED LIVING NUTRITION LLC
Practice address
7204 Amhurst Way
Clearwater, FL 33764-7001
Phone
(352) 584-6394
NPI assigned
Nov 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Brianna MahoneyNPI 1982322400
Title
Owner
Phone
(727) 238-5185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

7204 Amhurst Way
Clearwater, FL 33764-7001

Mailing address

7204 Amhurst Way
Clearwater, FL 33764-7001
Phone (352) 584-6394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251119000184 FL Part B Supplier - Clinic/Group Practice 8123519014 Receives reassigned benefits from 1 practitioner
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1629948567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 AMHURST WAY",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337647001",
            "telephone_number": "352-584-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 AMHURST WAY",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337647001",
            "telephone_number": "352-584-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-238-5185"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.