Organization Active NPI

Gotcha Nutrition & Wellness LLC

  • Registered Dietitian
  • Montclair, NJ
National Provider Identifier
1669251724
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
GOTCHA NUTRITION & WELLNESS LLC
Practice address
309 Orange Rd
Montclair, NJ 07042-4451
Phone
(908) 230-7648
Fax
(888) 649-4924
NPI assigned
Sep 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Ms. Tracylee Nicole Gottschalk, RD
Title
Registered Dietitian
Phone
(908) 230-7648

Specialties & licenses 1

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

Addresses

Primary practice location

309 Orange Rd
Montclair, NJ 07042-4451

Mailing address

309 Orange Rd
Montclair, NJ 07042-4451
Phone (908) 230-7648

Other practice location 1

49 Beverly Rd
Montclair, NJ 07043-2401
Phone (908) 230-7648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241223000489 NJ Part B Supplier - Clinic/Group Practice 1658808142 Receives reassigned benefits from 1 practitioner
Practice locations: Montclair, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1669251724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 ORANGE RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424451",
            "telephone_number": "908-230-7648",
            "fax_number": "888-649-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 ORANGE RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424451",
            "telephone_number": "908-230-7648",
            "fax_number": "888-649-4924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Beverly Rd",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070432401",
            "country_code": "US",
            "telephone_number": "908-230-7648",
            "fax_number": "888-649-4924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOTCHA NUTRITION & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "GOTTSCHALK",
        "authorized_official_first_name": "TRACYLEE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "908-230-7648",
        "authorized_official_name_prefix": "Ms.",
        "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 Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.