NPIMap

Organization Active NPI

Mindful Nutrition Counseling LLC

  • Registered Dietitian
  • Nacogdoches, TX
National Provider Identifier
1639889777
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MINDFUL NUTRITION COUNSELING LLC
Practice address
2400 N Stallings Dr
Nacogdoches, TX 75964-1222
Phone
(936) 205-1721
Fax
(866) 259-8676
NPI assigned
Nov 30, 2022
Last updated
Nov 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Authorized official

Name
Shelbie Calk Greenville
Title
Owner
Phone
(936) 205-1721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

2400 N Stallings Dr
Nacogdoches, TX 75964-1222

Mailing address

316 Edgewood Cir
Lufkin, TX 75904-7518
Phone (936) 205-1721

National Provider Directory

National Provider Directory
Tax ID family
Mindful Nutrition Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1639889777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 EDGEWOOD CIR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759047518",
            "telephone_number": "936-205-1721",
            "fax_number": "866-259-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759641222",
            "telephone_number": "936-205-1721",
            "fax_number": "866-259-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL NUTRITION COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "GREENVILLE",
        "authorized_official_first_name": "SHELBIE",
        "authorized_official_middle_name": "CALK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-205-1721"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.