NPIMap

Organization Active NPI

Nutrition Therapy LLC

  • Health Service Clinic/Center
  • Cumming, GA
National Provider Identifier
1841942398
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
NUTRITION THERAPY LLC
Doing business as
Nutrition Therapy LLC
Practice address
2510 Wood Fern LN
Cumming, GA 30041-3439
Phone
(404) 783-6505
NPI assigned
Jan 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Mrs. Dipali Panchal, RD, LDNPI 1902493679
Title
Dietitian
Phone
(404) 783-6505

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

2510 Wood Fern LN
Cumming, GA 30041-3439

Mailing address

2510 Wood Fern LN
Cumming, GA 30041-3439
Phone (404) 783-6505

Other identifiers 1

IdentifierTypeStateIssuer
1902493679MedicaidGA

Other names 1

  • Nutrition Therapy LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL nutritiontherapyllc@gmail.com Direct

National Provider Directory

National Provider Directory

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": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1841942398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 WOOD FERN LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300413439",
            "telephone_number": "404-783-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 WOOD FERN LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300413439",
            "telephone_number": "404-783-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "PANCHAL",
        "authorized_official_first_name": "DIPALI",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "404-783-6505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902493679",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "nutritiontherapyllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Nutrition counseling",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2510 Wood Fern Ln",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300413439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nutrition Therapy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.