Lynise Perry Nutrition

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

LYNISE PERRY NUTRITION

Practice address

557 River Creek Rd
Chesapeake, VA 23320-6233

Phone

(630) 812-8584

NPI assigned

Aug 4, 2019

Last updated

Aug 4, 2019By 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

Lynise Perry, CNS, LDN

Title

Nutritionist

Phone

(630) 812-8584

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lynise Perry Nutrition Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1564876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564876800000",
    "number": "1770138091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 RIVER CREEK RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233206233",
            "telephone_number": "630-812-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 RIVER CREEK RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233206233",
            "telephone_number": "630-812-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNISE PERRY NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-04",
        "last_updated": "2019-08-04",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "LYNISE",
        "authorized_official_title_or_position": "NUTRITIONIST",
        "authorized_official_telephone_number": "630-812-8584",
        "authorized_official_credential": "CNS, LDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770065922",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Chesapeake",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "557 River Creek Rd",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233206233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lynise Perry Nutrition",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Nutritionist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2019; 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.