Nutrition by Joey, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

844423 Issued in CA

Legal business name

NUTRITION BY JOEY, LLC

Practice address

8275 S Eastern Ave
Suite #118
Las Vegas, NV 89123-2591

Phone

(702) 878-5639

Fax

(480) 247-4481

NPI assigned

Dec 3, 2009

Last updated

Oct 8, 2015By 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. Joey Lyn Sjostrom, RDNPI 1396889507

Title

Owner

Phone

(702) 878-5639

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

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.

• Joey Lyn Sjostrom, RD

  • Registered Dietitian
  • Las Vegas, NV
  • NPI 1396889507

  Dietitian, Registered

  Medicare reassignment NPD Authorized official
• Julie Suckow, R.D.

  • Registered Dietitian
  • Wenatchee, WA
  • NPI 1396010666

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1740518638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10961 SHALLOW WATER CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890528721",
            "telephone_number": "702-878-5639",
            "fax_number": "480-247-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8275 S EASTERN AVE",
            "address_2": "SUITE #118",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232591",
            "telephone_number": "702-878-5639",
            "fax_number": "480-247-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION BY JOEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "SJOSTROM",
        "authorized_official_first_name": "JOEY",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-878-5639",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "844423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Dietitian in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.