Organization Active NPI

Kailo Nutrition

  • Registered Dietitian
  • Jacksonville, FL
National Provider Identifier
1801324280
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
KAILO NUTRITION
Practice address
353 B 6TH Street South
Jacksonville, FL 32250
Phone
(904) 250-0910
NPI assigned
May 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Authorized official

Name
Mrs. Heather Borders, RD, LD/N
Title
Owner
Phone
(904) 250-0910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

353 B 6TH Street South
Jacksonville, FL 32250

Mailing address

353 6TH Ave S
Jacksonville, FL 32250-5219
Phone (904) 250-0910

National Provider Directory

National Provider Directory

Locations

353 6th Ave S
Jacksonville Beach, FL 32250
Phone (904) 250-0910

353 6th Ave S
#B
Jacksonville Beach, FL 32250
Phone (904) 250-0910

507 4th St S
Jacksonville Beach, FL 32250
Phone (904) 503-2745

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1801324280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 6TH AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322505219",
            "telephone_number": "904-250-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 B 6TH STREET SOUTH",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-250-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAILO NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "BORDERS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-250-0910",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LD/N"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.