NPIMap

Organization Active NPI

Urban Nutrition, LLC

  • Registered Dietitian
  • Southlake, TX
National Provider Identifier
1649569336
Registry record updated Apr 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT81448 Issued in TX
Legal business name
URBAN NUTRITION, LLC
Practice address
1209 Timber CT
Southlake, TX 76092-9225
Phone
(817) 366-4643
NPI assigned
Apr 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2011

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

Authorized official

Name
Jessica Julstedt Coffee, RD, LDNPI 1073827994
Title
Registered Dietitian
Phone
(817) 366-4643

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 DT81448 TX Primary

Addresses

Primary practice location

1209 Timber CT
Southlake, TX 76092-9225

Mailing address

1209 Timber CT
Southlake, TX 76092-9225
Phone (817) 366-4643

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": "1301788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301788800000",
    "number": "1649569336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 TIMBER CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929225",
            "telephone_number": "817-366-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 TIMBER CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929225",
            "telephone_number": "817-366-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-03",
        "last_updated": "2011-04-03",
        "status": "A",
        "authorized_official_last_name": "COFFEE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "JULSTEDT",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "817-366-4643",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT81448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2011; 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.