Restore Wellness LLC

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

RESTORE WELLNESS LLC

Practice address

3407 Willow St
Anchorage, AK 99517-2106

Phone

(907) 830-9877

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Suanne F Sikkema, CNSNPI 1700245222

Title

Owner, Nutritionist

Phone

(907) 830-9877

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suanne Faith Sikkema, M.S., C.N.S.

  • Nutrition Education Nutritionist
  • Anchorage, AK
  • NPI 1700245222

  Nutrition, Education

  NPD Authorized official

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1669060760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91014",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995091014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILLOW ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995172106",
            "telephone_number": "907-830-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "SIKKEMA",
        "authorized_official_first_name": "SUANNE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER, NUTRITIONIST",
        "authorized_official_telephone_number": "907-830-9877",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CNS"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.