Organization Active NPI

Proud Peaceful Nutrition, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Coralville, IA
National Provider Identifier
1932083961
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PROUD PEACEFUL NUTRITION, LLC
Practice address
2751 Oakdale Blvd Ste 1
Coralville, IA 52241-9749
Phone
(319) 331-9017
Fax
(319) 469-8763
NPI assigned
Aug 4, 2025
Last updated
Jun 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Mrs. Stephanie L Proud, RDN, LD, CEDSNPI 1366439028
Title
Owner, Registered Dietitian
Phone
(319) 331-9017

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2751 Oakdale Blvd Ste 1
Coralville, IA 52241-9749

Mailing address

2751 Oakdale Blvd Ste 1
Coralville, IA 52241-9749
Phone (319) 331-9017

Other practice location 1

1720 Silver Maple Trl
North Liberty, IA 52317-4740
Phone (319) 331-9017

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": "1754265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1932083961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 OAKDALE BLVD STE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522419749",
            "telephone_number": "319-331-9017",
            "fax_number": "319-469-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 OAKDALE BLVD STE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522419749",
            "telephone_number": "319-331-9017",
            "fax_number": "319-469-8763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 Silver Maple Trl",
            "address_purpose": "LOCATION",
            "city": "North Liberty",
            "state": "IA",
            "postal_code": "523174740",
            "country_code": "US",
            "telephone_number": "319-331-9017",
            "fax_number": "319-469-8763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROUD PEACEFUL NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-04",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "PROUD",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "319-331-9017",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN, LD, CEDS"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.