Active NPI
MNT, Inc.
- Registered Dietitian
- Bowling Green, KY
National Provider Identifier
1881925428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- MNT, INC.
- Practice address
- 207 Traditions Blvd
Bowling Green, KY 42103-7957 - Phone
- (270) 901-3412
- Fax
- (270) 901-3413
- NPI assigned
- Jan 21, 2010
- Last updated
- Feb 19, 2020
- 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
- Mr. Douglas T Anderson
- Title
- Owner
- Phone
- (270) 901-3412
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | KY | Primary | |
| Registered Nurse | 163W00000X | KY | ||
| Specialist | 174400000X | KY |
Addresses
Primary practice location
207 Traditions Blvd
Bowling Green, KY 42103-7957
Mailing address
207 Traditions Blvd
Bowling Green, KY 42103-7957
Phone (270) 901-3412
Other practice location 1
201 Park St
Bowling Green, KY 42101-1742
Phone (270) 901-3412
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01616306 | Other | TN | AMERIGROUP TN |
| NONE | Other | KY | INTEGRATED HEALTH PLAN |
| NONE | Other | KY | OPTUM HEALTH |
| 01256 | Other | KY | MEDICARE P-TAN |
| NONE | Other | TN | BLUE CROSS BLUE SHIELD TN |
| 392072 | Other | TN | CIGNA TN |
| DQ0042 | Other | KY | RAILROAD MEDICARE |
| NONE | Other | KY | HUMANA KY |
| 1526503 | Other | TN | TENNCARE MEDICAID |
| 9566482 | Other | KY | AETNA |
| 000000334989 | Other | KY | ANTHEM |
| 103G709673 | Other | TN | MEDICARE P-TAN |
| NONE | Other | KY | BLUEGRASS FAMILY HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, TN, OH
Enrollment records 3
National Provider Directory
National Provider DirectoryLocations
730 Fairview Ave
Ste B1
Bowling Green, KY 42101
Phone (270) 781-3321
843 Fairview Ave
Ste B6
Bowling Green, KY 42101
Phone (270) 842-7254
1200 Breckenridge St
Owensboro, KY 42303
Phone (270) 683-8672
1994 Gallatin Pike N
Ste 30
Madison, TN 37115
1994 Gallatin Pike N
Ste 300
Madison, TN 37115
Phone (615) 856-1478
Practitioners & affiliated clinicians
Practitioners 21
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.
-
- Registered Dietitian
- Cincinnati, OH
- NPI 1407151012
Dietitian, Registered, KY, TN
-
- Clinical Social Worker
- Bowling Green, KY
- NPI 1841542453
-
- Registered Dietitian
- Nashville, TN
- NPI 1144201310
Dietitian, Registered
-
- Internal Medicine Physician
- Horse Cave, KY
- NPI 1619953700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1582070400000",
"number": "1881925428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 TRADITIONS BLVD",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037957",
"telephone_number": "270-901-3412",
"fax_number": "270-901-3413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 TRADITIONS BLVD",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037957",
"telephone_number": "270-901-3412",
"fax_number": "270-901-3413"
}
],
"practiceLocations": [
{
"address_1": "201 Park St",
"address_purpose": "LOCATION",
"city": "Bowling Green",
"state": "KY",
"postal_code": "421011742",
"country_code": "US",
"telephone_number": "270-901-3412",
"fax_number": "270-901-3413",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MNT, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-01-21",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "270-901-3412",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": null,
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KY",
"license": null,
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "KY",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP TN",
"identifier": "01616306",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTEGRATED HEALTH PLAN",
"identifier": "NONE",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM HEALTH",
"identifier": "NONE",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE P-TAN",
"identifier": "01256",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD TN",
"identifier": "NONE",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA TN",
"identifier": "392072",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DQ0042",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA KY",
"identifier": "NONE",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNCARE MEDICAID",
"identifier": "1526503",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9566482",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000334989",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE P-TAN",
"identifier": "103G709673",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUEGRASS FAMILY HEALTH",
"identifier": "NONE",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.