Waccamaw Nutrition

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

WACCAMAW NUTRITION

Doing business as

Bite Into Wellness

Practice address

100 Roberts Rd
Georgetown, SC 29440-6898

Phone

(843) 485-2234

NPI assigned

Jul 14, 2020

Last updated

Aug 10, 2020By 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

Kelsey Tiller, RD, LDNPI 1114341708

Title

Authorized Member

Phone

(843) 485-2234

Specialties & licenses 1

Addresses

Other names 1

• Bite Into Wellness Doing business as

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.

• Kelsey Tiller, RD, LD

  • Registered Dietitian
  • Georgetown, SC
  • NPI 1114341708
  Authorized official Same address or phone

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1700404985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROBERTS RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406898",
            "telephone_number": "843-485-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROBERTS RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406898",
            "telephone_number": "843-485-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "TILLER",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "843-485-2234",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bite Into Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bite Into Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Waccamaw Oncology, PA
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• Wal-Mart Stores East LP (Walmart Pharmacy 10-0625)
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• Registered Dietitian in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.