Organization Active NPI

Nutrition With Heart LLC

  • Registered Dietitian
  • Edmonds, WA
National Provider Identifier
1871157487
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION WITH HEART LLC
Practice address
221 4TH Ave N
Edmonds, WA 98020-3116
Phone
(509) 481-0884
NPI assigned
Apr 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Mr. Michael James Lynch, REGISTERED DIETITIANNPI 1255750097
Title
Founder
Phone
(509) 481-0884

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133NN1002X
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X Primary
Renal Nutrition Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133VN1005X
Metabolic Nutrition Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133VN1006X

Addresses

Primary practice location

221 4TH Ave N
Edmonds, WA 98020-3116

Mailing address

221 4TH Ave N
Edmonds, WA 98020-3116
Phone (509) 481-0884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190815003708 WA Part B Supplier - Clinic/Group Practice 4688901416 Receives reassigned benefits from 1 practitioner
Practice locations: Edmonds, WA

National Provider Directory

National Provider Directory

Locations

221 4th Ave N
Edmonds, WA 98020
Phone (425) 697-2100

Practitioners & affiliated clinicians

Practitioners 2

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": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1871157487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 4TH AVE N",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203116",
            "telephone_number": "509-481-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 4TH AVE N",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203116",
            "telephone_number": "509-481-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION WITH HEART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "509-481-0884",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REGISTERED DIETITIAN"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.