The Sweet Life Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

THE SWEET LIFE NUTRITION LLC

Practice address

4513 Willet Dr
Annandale, VA 22003-3944

Phone

(703) 831-2125

NPI assigned

Aug 31, 2017

Organization subpart

No

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

Authorized official

Name

Amanda Boostrom, MS, RDNNPI 1578900684

Title

Owner/Registered Dietitian

Phone

(703) 831-2125

Specialties & licenses 1

Addresses

Practitioners 1

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

• Amanda Boostrom, RDN

  • Registered Dietitian
  • Annandale, VA
  • NPI 1578900684

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504137600000",
    "number": "1790203677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 WILLET DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4513 WILLET DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033944",
            "telephone_number": "703-831-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SWEET LIFE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A",
        "authorized_official_last_name": "BOOSTROM",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "703-831-2125",
        "authorized_official_credential": "MS, 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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• Registered Dietitian in Annandale, VA
• Providers in Annandale, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.