Active NPI
Kailo Nutrition
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1801324280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 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 DirectoryLocations
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.