Organization Active NPI

Inspiring Change Nutrition LLC

  • Registered Dietitian
  • West Deptford, NJ
National Provider Identifier
1720738511
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
INSPIRING CHANGE NUTRITION LLC
Practice address
1303 Royal LN
West Deptford, NJ 08086-2312
Phone
(609) 634-4714
NPI assigned
Mar 25, 2022
Last updated
Mar 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Elizabeth Sierzega, RD, CNSCNPI 1629520994
Title
Registered Dietitian
Phone
(609) 634-4714

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 DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

1303 Royal LN
West Deptford, NJ 08086-2312

Mailing address

1303 Royal LN
West Deptford, NJ 08086-2312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220414000241 NJ Part B Supplier - Clinic/Group Practice 9335535616 Receives reassigned benefits from 1 practitioner
Practice locations: West Deptford, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1720738511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 ROYAL LN",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 ROYAL LN",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862312",
            "telephone_number": "609-634-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSPIRING CHANGE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "SIERZEGA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "609-634-4714",
        "authorized_official_credential": "RD, CNSC"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.