Third Endeavor LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD002860 Issued in GA

Legal business name

THIRD ENDEAVOR LLC

Practice address

17 Hampshire CT
Avondale Estates, GA 30002-1537

Phone

(404) 435-8375

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Karla Coffee-Dunning, RD

Title

Registered Dietitian

Phone

(404) 435-8375

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1740654656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HAMPSHIRE CT",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021537",
            "telephone_number": "404-435-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HAMPSHIRE CT",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300021537",
            "telephone_number": "404-435-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD ENDEAVOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "COFFEE-DUNNING",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "404-435-8375",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD002860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anneliese Amanda Singh, PH.D.
• Charise Smith
• Amanda Stentiford, DPT
• Amy Lynne Stern, LCSW
• Lisa D Taylor, PHD, TLP, LCSW
• Kevin Thrailkill, LCSW
• John E. Titak, O.D.
• Trident Counseling and Consultation, LLC
• Jacqueline Varnum, PT, DPT, OCS, CSCS
• Verve Health LLC Dba Lyva Primary Care and Wellness Center

• All providers in Avondale Estates, GA
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.