Organization Active NPI

Nutrition for Performance

  • Registered Dietitian
  • Boston, MA
National Provider Identifier
1922768993
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION FOR PERFORMANCE
Practice address
31 Saint James Ave
Boston, MA 02116-4101
Phone
(360) 441-0349
NPI assigned
Dec 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Daniel Goebel, RD, LDNNPI 1083220586
Title
Owner
Phone
(360) 441-0349

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

31 Saint James Ave
Boston, MA 02116-4101

Mailing address

56 Prince St Apt 1
Boston, MA 02113-1826
Phone (360) 441-0349

Other identifiers 1

IdentifierTypeStateIssuer
1083220586MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgoebel@nimrd.com Direct

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": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1922768993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 PRINCE ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131826",
            "telephone_number": "360-441-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SAINT JAMES AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164101",
            "telephone_number": "360-441-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION FOR PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "GOEBEL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-441-0349",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083220586",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgoebel@nimrd.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "31 Saint James Ave",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021164101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.