Lifetime Nutrition and Wellness LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

LIFETIME NUTRITION AND WELLNESS LLC

Practice address

5592 Davis Blvd
N Richland Hills, TX 76180-5202

Phone

(817) 718-9412

NPI assigned

Jun 19, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Ann Glaser, RDN

Title

Owner/ Dietitian

Phone

(402) 802-2639

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1639739816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820472",
            "city": "N RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761820472",
            "telephone_number": "817-718-9412",
            "fax_number": "682-200-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5592 DAVIS BLVD",
            "city": "N RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761805202",
            "telephone_number": "817-718-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME NUTRITION AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/ DIETITIAN",
        "authorized_official_telephone_number": "402-802-2639",
        "authorized_official_name_prefix": "Ms.",
        "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": []
}

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• Registered Dietitian in N Richland Hills, TX
• Providers in N Richland Hills, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.