Ignite Performance Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

IGNITE PERFORMANCE NUTRITION, LLC

Doing business as

Ignite Nutrition Services

Practice address

71 N Jackson St
Forsyth, GA 31029-2168

Phone

(580) 279-0109

NPI assigned

Apr 19, 2024

Last updated

Apr 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Lynn Hoover, RD, LDNPI 1548433212

Title

Registered Dietitian

Phone

(580) 279-0109

Specialties & licenses 4

Addresses

Other names 1

• Ignite Nutrition Services Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Lynn Hoover, R.D., L.D.

  • Registered Dietitian
  • Forsyth, GA
  • NPI 1548433212

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1669227005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BELMONT WAY",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310295372",
            "telephone_number": "580-279-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 N JACKSON ST",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310292168",
            "telephone_number": "580-279-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE PERFORMANCE NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "580-279-0109",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ignite Nutrition Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ignite Nutrition Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sophia Holland
• Melissa Lynn Hoover, R.D., L.D.
• Charles Joseph Hortman Jr.
• Hospitalmd PTC Ga, Inc
• Hospitalmd PTC Ip, Inc
• Ingles Markets Inc
• Internal Medicine Associates of Middle Georgia, P.C.
• JM Cardinal Investments LLC
• Amber R. Johnston, LMSW
• Marissa Jones, LPC

• Registered Dietitian in Forsyth, GA
• Providers in Forsyth, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.