Primary Health & Nutrition Services Inc.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041-249653 Issued in IL

Legal business name

PRIMARY HEALTH & NUTRITION SERVICES INC.

Practice address

514 Cottonwood Rd
Frankfort, IL 60423-1010

Phone

(815) 546-9496

Fax

(815) 469-4136

NPI assigned

Mar 4, 2017

Organization subpart

No

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

Authorized official

Name

Susan Lewis, R.N.CDDN

Title

RN

Phone

(815) 546-9496

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1488585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488585600000",
    "number": "1659811073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 COTTONWOOD RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231010",
            "telephone_number": "815-546-9496",
            "fax_number": "815-469-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 COTTONWOOD RD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231010",
            "telephone_number": "815-546-9496",
            "fax_number": "815-469-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH & NUTRITION SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-04",
        "last_updated": "2017-03-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "815-546-9496",
        "authorized_official_credential": "R.N.CDDN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-249653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360-62-0745-001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2017; 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.