NPIMap

Organization Active NPI

Medical Nutritional Therapists, Inc.

  • Metabolic Nutrition Registered Dietitian
  • Louisville, KY
National Provider Identifier
1891801791
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
MEDICAL NUTRITIONAL THERAPISTS, INC.
Practice address
410 Finzer Street #302
Louisville, KY 40203
Phone
(800) 245-9009
Fax
(260) 489-5057
NPI assigned
Aug 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James A Holb, RD LD CDENPI 1740217819
Title
Owner/Vice President
Phone
(260) 489-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X Primary

Addresses

Primary practice location

410 Finzer Street #302
Louisville, KY 40203

Mailing address

4210 Flagstaff CV
Fort Wayne, IN 46815-4417
Phone (260) 489-9009

Other identifiers 3

IdentifierTypeStateIssuer
1972545507OtherOHNPI
2465612MedicaidOH
1619919263OtherINNPI

National Provider Directory

National Provider Directory
Tax ID family
Medical Nutritional Therapists Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891801791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 FLAGSTAFF CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154417",
            "telephone_number": "260-489-9009",
            "fax_number": "260-489-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FINZER STREET #302",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40203",
            "telephone_number": "800-245-9009",
            "fax_number": "260-489-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL NUTRITIONAL THERAPISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLB",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/VICE PRESIDENT",
        "authorized_official_telephone_number": "260-489-9009",
        "authorized_official_credential": "RD LD CDE"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972545507",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2465612",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619919263",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.