NPIMap

Organization Active NPI

Health Wellness Pack

  • Registered Dietitian
  • Columbia, MD
National Provider Identifier
1851001259
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
HEALTH WELLNESS PACK
Practice address
6127 Jerrys Dr
Columbia, MD 21044-3824
Phone
(443) 285-1454
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Authorized official

Name
Daphene Altema-Johnson, RDN,MBA,MPHNPI 1487379798
Title
Dietitian
Phone
(443) 285-1454

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 Dietitian 133V00000X NU Primary

Addresses

Primary practice location

6127 Jerrys Dr
Columbia, MD 21044-3824

Mailing address

6127 Jerrys Dr
Columbia, MD 21044-3824

Other identifiers 1

IdentifierTypeStateIssuer
DX5601OtherMDRDN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL healthwellnesspack.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, 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": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1851001259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 JERRYS DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6127 JERRYS DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443824",
            "telephone_number": "443-285-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH WELLNESS PACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "ALTEMA-JOHNSON",
        "authorized_official_first_name": "DAPHENE",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "443-285-1454",
        "authorized_official_credential": "RDN,MBA,MPH"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDN LICENSE",
            "identifier": "DX5601",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "healthwellnesspack.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "6127 Jerrys Dr",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.