Annie Burdine Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

ANNIE BURDINE NUTRITION, LLC

Practice address

184 Main St Rear
Emmaus, PA 18049-4015

Phone

(484) 347-9055

NPI assigned

Sep 4, 2019

Last updated

Feb 5, 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

Mrs. Anne E Burdine, RD, LDNNPI 1083966469

Title

Owner

Phone

(610) 573-1365

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Defore-Burdine, LLC Former legal business name

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.

• Anne Burdine, RD

  • Registered Dietitian
  • Allentown, PA
  • NPI 1083966469

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1700435559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 DAVID DR",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180499606",
            "telephone_number": "610-573-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 MAIN ST REAR",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180494015",
            "telephone_number": "484-347-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNIE BURDINE NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "BURDINE",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-573-1365",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083966469",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Defore-Burdine, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Registered Dietitian in Emmaus, PA
• Providers in Emmaus, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.