NPIMap

Organization Active NPI

Komplete Nutrition LLC

  • Registered Dietitian
  • Ogden, UT
National Provider Identifier
1811769219
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
KOMPLETE NUTRITION LLC
Practice address
2835 Porter Ave
Ogden, UT 84403-0125
Phone
(801) 995-9458
NPI assigned
Oct 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Authorized official

Name
Kylie PetersonNPI 1699134809
Title
Owner/Dietitian
Phone
(801) 995-9458

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2835 Porter Ave
Ogden, UT 84403-0125

Mailing address

2835 Porter Ave
Ogden, UT 84403-0125

Other practice location 1

295 S Main St
Pleasant Grove, UT 84062-2632
Phone (719) 290-0002

National Provider Directory

National Provider Directory

Locations

2909 Washington Blvd
Ste 209
Ogden, UT 84401
Phone (801) 796-2763

2902 Washington Blvd
Ogden, UT 84401

Practitioners & affiliated clinicians

Practitioners 4

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": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1811769219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 PORTER AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844030125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 PORTER AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844030125",
            "telephone_number": "801-995-9458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 S Main St",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840622632",
            "country_code": "US",
            "telephone_number": "719-290-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOMPLETE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KYLIE",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "801-995-9458"
    },
    "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 Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.