Organization Active NPI

So Nutrition, LLC

  • Registered Dietitian
  • Katy, TX
National Provider Identifier
1811247158
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT80576 Issued in TX
Legal business name
SO NUTRITION, LLC
Practice address
5318 Dandelion Meadow LN
Katy, TX 77494-4887
Phone
(281) 394-5734
NPI assigned
Sep 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Mrs. Stephanie L Oullette, RD
Title
Owner
Phone
(281) 394-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X DT80576 TX Primary

Addresses

Primary practice location

5318 Dandelion Meadow LN
Katy, TX 77494-4887

Mailing address

5318 Dandelion Meadow LN
Katy, TX 77494-4887
Phone (281) 394-5734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120924000642 TX Part B Supplier - Clinic/Group Practice 6901054550 Receives reassigned benefits from 1 practitioner
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

21815 Oak Park Trails Dr
Katy, TX 77450
Phone (281) 684-4733

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1811247158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 DANDELION MEADOW LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944887",
            "telephone_number": "281-394-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5318 DANDELION MEADOW LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944887",
            "telephone_number": "281-394-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "OULLETTE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-394-5734",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.