Nourish360 LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NOURISH360 LLC

Practice address

117 Mahogany LN
King of Prussia, PA 19406-2299

Phone

(610) 635-9942

NPI assigned

Jun 22, 2020

Organization subpart

No

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

Authorized official

Name

Nicholas Mosakowski, RDNNPI 1912523374

Title

Owner

Phone

(610) 635-9942

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

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

• Nicholas David Mosakowski, RDN

  • Registered Dietitian
  • King of Prussia, PA
  • NPI 1912523374
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1780200147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MAHOGANY LN",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062299",
            "telephone_number": "610-635-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAHOGANY LN",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062299",
            "telephone_number": "610-635-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "MOSAKOWSKI",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-635-9942",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marcelle F Norwood, CRNA
• Nourish Functional Nutrition, LLC
• Monica Lynn Nugent, MS, OTRL
• Qendresa Nuredini
• Stephanie Nuse
• Christiana Nwogu, FNP-BC
• Brittany O'Brien

• Registered Dietitian in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.

Verify at the official NPI Registry.