Nutrition Therapy New Mexico LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-0659 Issued in NM

Legal business name

NUTRITION THERAPY NEW MEXICO LLC

Practice address

2185 44TH St
Ste D
Los Alamos, NM 87544-1750

Phone

(505) 412-5983

NPI assigned

Oct 1, 2014

Organization subpart

No

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

Authorized official

Name

Mary Patricia Willms, RD

Title

Ceo/Medical Director

Phone

(505) 412-5983

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1710380910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 44TH ST",
            "address_2": "STE D",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875441750",
            "telephone_number": "505-412-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 44TH ST",
            "address_2": "STE D",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875441750",
            "telephone_number": "505-412-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION THERAPY NEW MEXICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "WILLMS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "505-412-5983",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD-0659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Registered Dietitian in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.