NPIMap

Organization Active NPI

Ouellette Nutrition LLC

  • Registered Dietitian
  • South Windsor, CT
National Provider Identifier
1760076178
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
OUELLETTE NUTRITION LLC
Doing business as
Common Roots Nutrition
Practice address
22 Carson Way
South Windsor, CT 06074-1847
Phone
(860) 222-0867
NPI assigned
Feb 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Michael Ouellette, RDN, CDNNPI 1043812886
Title
Owner/Managing Member
Phone
(860) 222-0867

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

22 Carson Way
South Windsor, CT 06074-1847

Mailing address

22 Carson Way
South Windsor, CT 06074-1847
Phone (860) 222-0867

Other names 1

  • Common Roots Nutrition Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1760076178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CARSON WAY",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060741847",
            "telephone_number": "860-222-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CARSON WAY",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060741847",
            "telephone_number": "860-222-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUELLETTE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "860-222-0867",
        "authorized_official_credential": "RDN, CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Common Roots Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.