NPIMap

Organization Active NPI

Complete Medical Nutrition Therapy LLC

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1881470433
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
COMPLETE MEDICAL NUTRITION THERAPY LLC
Practice address
6432 S 47TH St
Phoenix, AZ 85042-5349
Phone
(602) 410-3694
NPI assigned
Sep 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Zulema Aryssa JackmanNPI 1578154142
Title
Owner
Phone
(602) 410-3694

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 DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

6432 S 47TH St
Phoenix, AZ 85042-5349

Mailing address

3104 E Camelback Rd Unit 7615
Phoenix, AZ 85016-4502
Phone (602) 410-3694

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": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1881470433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 E CAMELBACK RD UNIT 7615",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164502",
            "telephone_number": "602-410-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6432 S 47TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425349",
            "telephone_number": "602-410-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE MEDICAL NUTRITION THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "JACKMAN",
        "authorized_official_first_name": "ZULEMA",
        "authorized_official_middle_name": "ARYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-410-3694"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.