Real Nutrition by Crystal LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

REAL NUTRITION BY CRYSTAL LLC

Practice address

241 N C St Ste 1F
Anchorage, AK 99501-1665

Phone

(907) 727-8613

NPI assigned

Jan 30, 2021

Organization subpart

No

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

Authorized official

Name

Crystal M Flores, MS, RDN, LDN, CLTNPI 1467987719

Title

Owner

Phone

(907) 727-8613

Specialties & licenses 1

Addresses

Other names 1

• Real Nutrition By Crystal PLLC Former legal business name

Electronic endpoints 2

Locations

Practitioners 1

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

• Crystal Mardin Flores, MS RD LDN

  • Registered Dietitian
  • Anchorage, AK
  • NPI 1467987719

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1811588015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220224",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995220224",
            "telephone_number": "907-727-8613",
            "fax_number": "585-302-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 N C ST STE 1F",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995011665",
            "telephone_number": "907-727-8613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960D Thomas Ave",
            "address_purpose": "LOCATION",
            "city": "Irondequoit",
            "state": "NY",
            "postal_code": "146171445",
            "country_code": "US",
            "telephone_number": "585-354-5677",
            "fax_number": "585-302-2717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REAL NUTRITION BY CRYSTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-30",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-727-8613",
        "authorized_official_credential": "MS, RDN, LDN, CLT"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://realnutritionbycrystal.practicebetter.io/#/5d2f40e4627db313b8fc4fcf/profile",
            "affiliation": "N",
            "endpointDescription": "Practice Management Software",
            "address_1": "241 N C St Ste 1F",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995011665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://realnutritionbycrystal.practicebetter.io/#/5d2f40e4627db313b8fc4fcf/profile",
            "affiliation": "N",
            "endpointDescription": "Practice Management Software",
            "address_1": "960D Thomas Ave",
            "city": "Irondequoit",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146171445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Real Nutrition By Crystal PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Registered Dietitian in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Registered Dietitian in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.