NPIMap

Organization Active NPI

Jenna Gorham Nutrition Consulting

  • Registered Dietitian
  • Bozeman, MT
National Provider Identifier
1821549015
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
49765 Issued in MT
Legal business name
JENNA GORHAM NUTRITION CONSULTING
Practice address
601 Nikles Dr Ste 11
Bozeman, MT 59715-2570
Phone
(508) 904-3454
NPI assigned
Oct 22, 2016
Last updated
Oct 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Jenna Marie Gorham, RDNPI 1629877568
Title
Owner
Phone
(508) 904-3454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 49765 MT Primary

Addresses

Primary practice location

601 Nikles Dr Ste 11
Bozeman, MT 59715-2570

Mailing address

601 Nikles Dr Ste 11
Bozeman, MT 59715-2570
Phone (508) 904-3454

National Provider Directory

National Provider Directory

Locations

601 Nikles Dr
Ste 11
Bozeman, MT 59715
Phone (508) 904-3454

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1477094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1821549015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NIKLES DR STE 11",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152570",
            "telephone_number": "508-904-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NIKLES DR STE 11",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152570",
            "telephone_number": "508-904-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNA GORHAM NUTRITION CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-22",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "GORHAM",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-904-3454",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MT",
            "license": "49765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.