NPIMap

Organization Active NPI

Body for Life, LLC

  • Registered Dietitian
  • Eatonton, GA
National Provider Identifier
1922326982
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
0107063 Issued in GA
Legal business name
BODY FOR LIFE, LLC
Practice address
136 E River Bend Dr
Eatonton, GA 31024-5353
Phone
(678) 773-1853
NPI assigned
May 13, 2010
Last updated
May 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Authorized official

Name
Mrs. Stacy Ann Paine, RD, LDNPI 1154576445
Title
Owner
Phone
(678) 773-1853

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 0107063 GA Primary

Addresses

Primary practice location

136 E River Bend Dr
Eatonton, GA 31024-5353

Mailing address

136 E River Bend Dr
Eatonton, GA 31024-5353

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, 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": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1922326982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E RIVER BEND DR",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E RIVER BEND DR",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245353",
            "telephone_number": "678-773-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY FOR LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-773-1853",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "0107063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatonton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.