Organization Active NPI

Vida Eats, LLC

  • Renal Nutrition Registered Dietitian
  • St Petersburg, FL
National Provider Identifier
1902515521
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
Legal business name
VIDA EATS, LLC
Practice address
699 16TH Ave S
St Petersburg, FL 33701-5407
Phone
(860) 944-0232
NPI assigned
Nov 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Alana Benito, RD
Title
Ceo
Phone
(860) 944-0232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1005X Primary

Addresses

Primary practice location

699 16TH Ave S
St Petersburg, FL 33701-5407

Mailing address

699 16TH Ave S
St Petersburg, FL 33701-5407
Phone (860) 944-0232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230126002318 FL Part B Supplier - Clinic/Group Practice 9436520657 Receives reassigned benefits from 1 practitioner
Practice locations: St Petersburg, FL
O20240826001508 NJ Part B Supplier - Clinic/Group Practice 9436520657 Receives reassigned benefits from 1 practitioner
Practice locations: Somerset, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1902515521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 16TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337015407",
            "telephone_number": "860-944-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 16TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337015407",
            "telephone_number": "860-944-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA EATS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "BENITO",
        "authorized_official_first_name": "ALANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-944-0232",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

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

Verify at the official NPI Registry.