NPIMap

Organization Active NPI

Medical Nutrition Therapy of Florida, Inc.

  • Registered Dietitian
  • Jacksonville, FL
National Provider Identifier
1871600700
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MEDICAL NUTRITION THERAPY OF FLORIDA, INC.
Practice address
4237 Salisbury Rd N
Ste 314
Jacksonville, FL 32257-8029
Phone
(904) 724-2043
Fax
(904) 724-2013
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Catherine L Trcalek, RDN, LDN
Title
President
Phone
(904) 724-2043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

4237 Salisbury Rd N
Ste 314
Jacksonville, FL 32257-8029

Mailing address

4237 Salisbury Rd N
Ste 314
Jacksonville, FL 32257-8029
Phone (904) 724-2043

Other identifiers 1

IdentifierTypeStateIssuer
165968OtherFLHEALTHEASE/WELLCARE

Other names 1

  • Medical Nutrition Therapy of FL, Inc. Other name

National Provider Directory

National Provider Directory

Locations

3100 University Blvd S
Ste 220
Jacksonville, FL 32216
Phone (904) 724-2043

4237 Salisbury Rd
Ste 314
Jacksonville, FL 32216
Phone (904) 724-2043

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners & affiliated clinicians

Practitioners 8

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1871600700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 SALISBURY RD N",
            "address_2": "STE 314",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578029",
            "telephone_number": "904-724-2043",
            "fax_number": "904-724-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 SALISBURY RD N",
            "address_2": "STE 314",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578029",
            "telephone_number": "904-724-2043",
            "fax_number": "904-724-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL NUTRITION THERAPY OF FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "TRCALEK",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-724-2043",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHEASE/WELLCARE",
            "identifier": "165968",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Nutrition Therapy of FL, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.