Organization Active NPI

Tera Naset Nutrition, LLC

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1720712805
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
TERA NASET NUTRITION, LLC
Practice address
708 W Brookwood CT
Phoenix, AZ 85045-0617
Phone
(708) 308-9188
NPI assigned
Jul 13, 2022
Last updated
Jul 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Tera Naset, RDNPI 1487076360
Title
Owner
Phone
(708) 308-9188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

708 W Brookwood CT
Phoenix, AZ 85045-0617

Mailing address

708 W Brookwood CT
Phoenix, AZ 85045-0617
Phone (708) 308-9188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201002831 AZ Part B Supplier - Clinic/Group Practice 6305214966 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1720712805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 W BROOKWOOD CT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850450617",
            "telephone_number": "708-308-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W BROOKWOOD CT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850450617",
            "telephone_number": "708-308-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERA NASET NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "NASET",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-308-9188",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.