NPIMap

Organization Active NPI

Nutriacs LLC

  • Registered Dietitian
  • Memphis, TN
National Provider Identifier
1659736023
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRIACS LLC
Practice address
8295 Tournament Dr Ste 150
Memphis, TN 38125-8900
Phone
(901) 969-4561
NPI assigned
Dec 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Ms. Ayesha GhaniNPI 1912449711
Title
Clinic Manager
Phone
(901) 647-5188

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133N00000X
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

8295 Tournament Dr Ste 150
Memphis, TN 38125-8900

Mailing address

9267 Breakstone CV
Collierville, TN 38017-9740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180619001380 TN Part B Supplier - Clinic/Group Practice 4183979941 Receives reassigned benefits from 1 practitioner
Practice locations: Collierville, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1659736023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9267 BREAKSTONE CV",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8295 TOURNAMENT DR STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258900",
            "telephone_number": "901-969-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIACS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "GHANI",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "901-647-5188",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.