Active NPI
Main Line Nutrition and Fitness LLC
- Registered Dietitian
- Wayne, PA
National Provider Identifier
1750077129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- MAIN LINE NUTRITION AND FITNESS LLC
- Practice address
- 215 Sugartown Rd
Wayne, PA 19087-3137 - Phone
- (610) 513-0525
- NPI assigned
- Apr 17, 2023
- Last updated
- Apr 17, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lauren M George, MS RD LDN
- Title
- Registered Dietitan Nutritionist
- Phone
- (610) 513-0525
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
215 Sugartown Rd
Wayne, PA 19087-3137
Mailing address
176 Grubb Rd
Malvern, PA 19355-3504
Phone (610) 513-0525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
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.
-
- Registered Dietitian
- Phoenixville, PA
- NPI 1154779221
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681689600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681689600000",
"number": "1750077129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176 GRUBB RD",
"city": "MALVERN",
"state": "PA",
"postal_code": "193553504",
"telephone_number": "610-513-0525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 SUGARTOWN RD",
"city": "WAYNE",
"state": "PA",
"postal_code": "190873137",
"telephone_number": "610-513-0525"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAIN LINE NUTRITION AND FITNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-17",
"last_updated": "2023-04-17",
"certification_date": "2023-04-17",
"status": "A",
"authorized_official_last_name": "GEORGE",
"authorized_official_first_name": "LAUREN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "REGISTERED DIETITAN NUTRITIONIST",
"authorized_official_telephone_number": "610-513-0525",
"authorized_official_credential": "MS RD LDN"
},
"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 Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.