Organization Active NPI

Litholyte Corporation, LLC

  • Medical Foods Supplier
  • New Bern, NC
National Provider Identifier
1710570577
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Foods SupplierTaxonomy code 335G00000X
Legal business name
LITHOLYTE CORPORATION, LLC
Practice address
2129 S Glenburnie Rd Ste 18
New Bern, NC 28562-2240
Phone
(252) 671-2032
NPI assigned
Feb 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Authorized official

Name
Dr. Ryan Holland, MD
Title
Owner
Phone
(618) 248-7283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Foods Supplier 335G00000X Primary

Addresses

Primary practice location

2129 S Glenburnie Rd Ste 18
New Bern, NC 28562-2240

Mailing address

3505 Barons Way
Trent Woods, NC 28562-4549
Phone (252) 671-2032

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1710570577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 BARONS WAY",
            "city": "TRENT WOODS",
            "state": "NC",
            "postal_code": "285624549",
            "telephone_number": "252-671-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 S GLENBURNIE RD STE 18",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622240",
            "telephone_number": "252-671-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITHOLYTE CORPORATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-248-7283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "335G00000X",
            "taxonomy_group": "",
            "desc": "Medical Foods Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.