Revitalized Health and Wellness Counseling

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

REVITALIZED HEALTH AND WELLNESS COUNSELING

Practice address

2539 Granberry PT
Missouri City, TX 77459-1389

Phone

(281) 794-4539

NPI assigned

Jul 4, 2022

Organization subpart

No

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

Authorized official

Name

Stacie Smith, MS, RD, LDNPI 1003549510

Title

Co-Owner

Phone

(281) 794-4539

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacie Smith, MS, RD, LD

  • Registered Dietitian
  • Sugar Land, TX
  • NPI 1003549510

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656892800000",
    "number": "1760115109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRANTS LAKE BLVD UNIT 17863",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774960887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 GRANBERRY PT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591389",
            "telephone_number": "281-794-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZED HEALTH AND WELLNESS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-04",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "281-794-4539",
        "authorized_official_credential": "MS, RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Missouri City, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; 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.