Nutritionmagic, Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD000961 Issued in GA

Legal business name

NUTRITIONMAGIC, INC.

Practice address

4054 Soaring Hawk Circle
11563 Big Canoe
Jasper, GA 30143-5115

Phone

(706) 579-1992

Fax

(866) 900-4295

NPI assigned

Mar 2, 2010

Last updated

Mar 2, 2010By 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

Mrs. Ann C. Lafontaine, MA,RD,LDNPI 1669570917

Title

President

Phone

(706) 579-1992

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Ann Caroline Lafontaine, MA, RD, LD

  • Registered Dietitian
  • Big Canoe, GA
  • NPI 1669570917

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1639492879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 SOARING HAWK CIRCLE",
            "address_2": "11563 BIG CANOE",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435115",
            "telephone_number": "706-579-1992",
            "fax_number": "866-900-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 SOARING HAWK CIRCLE",
            "address_2": "11563 BIG CANOE",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435115",
            "telephone_number": "706-579-1992",
            "fax_number": "866-900-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITIONMAGIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "LAFONTAINE",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-579-1992",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA,RD,LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD000961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669570917",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Jasper, GA
• Providers in Jasper, 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 2, 2010; 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.