NPIMap

Organization Active NPI

Make Life Peachy

  • Registered Dietitian
  • San Antonio, TX
National Provider Identifier
1669129557
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MAKE LIFE PEACHY
Practice address
22426 Carriage Bush
San Antonio, TX 78261-4416
Phone
(713) 416-8829
NPI assigned
Mar 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Allison Nicole Bourgeois, RDNPI 1942957832
Title
Dietitian
Phone
(713) 416-8829

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 Primary

Addresses

Primary practice location

22426 Carriage Bush
San Antonio, TX 78261-4416

Mailing address

22426 Carriage Bush
San Antonio, TX 78261-4416
Phone (713) 416-8829

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1669129557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22426 CARRIAGE BUSH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782614416",
            "telephone_number": "713-416-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22426 CARRIAGE BUSH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782614416",
            "telephone_number": "713-416-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKE LIFE PEACHY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "BOURGEOIS",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "713-416-8829",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.