Active NPI
Whole Nutrition Center, LLC
- Registered Dietitian
- Rockaway, NJ
National Provider Identifier
1871184028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- WHOLE NUTRITION CENTER, LLC
- Practice address
- 25 Pine St Ste 4
Rockaway, NJ 07866-3143 - Phone
- (862) 309-9859
- Fax
- (908) 509-6734
- NPI assigned
- Jan 31, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sara Victoria Monk, RD
- Title
- Owner
- Phone
- (201) 874-4968
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
25 Pine St Ste 4
Rockaway, NJ 07866-3143
Mailing address
8 Algonquin Ave
Rockaway, NJ 07866
Phone (201) 874-4968
Other practice location 1
21 Pine St Ste 106
Rockaway, NJ 07866-3130
Phone (862) 309-9859
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871184028 | Medicaid | NJ |
Other names 1
- Mindful Meals Nutrition Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210316001833 | NJ | Part B Supplier - Clinic/Group Practice | 8628484623 |
Receives reassigned benefits from 3 practitioners Practice locations: Rockaway, NJ |
National Provider Directory
National Provider DirectoryLocations
154 US Highway 206
Ste 2E
Chester, NJ 07930
21 Pine St
Ste 106
Rockaway, NJ 07866
Phone (201) 874-4968
Practitioners & affiliated clinicians
Practitioners 7
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": "1612051200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683590400000",
"number": "1871184028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 ALGONQUIN AVE",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "07866",
"telephone_number": "201-874-4968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 PINE ST STE 4",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078663143",
"telephone_number": "862-309-9859",
"fax_number": "908-509-6734"
}
],
"practiceLocations": [
{
"address_1": "21 Pine St Ste 106",
"address_purpose": "LOCATION",
"city": "Rockaway",
"state": "NJ",
"postal_code": "078663130",
"country_code": "US",
"telephone_number": "862-309-9859",
"fax_number": "908-509-6734",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WHOLE NUTRITION CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-31",
"last_updated": "2023-05-09",
"certification_date": "2023-05-09",
"status": "A",
"authorized_official_last_name": "MONK",
"authorized_official_first_name": "SARA",
"authorized_official_middle_name": "VICTORIA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "201-874-4968",
"authorized_official_credential": "RD"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871184028",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mindful Meals Nutrition Services",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Mindful Meals Nutrition Services",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Rockaway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.