Up4 Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

UP4 NUTRITION LLC

Doing business as

UP4 Nutrition

Practice address

3417 Spectrum Blvd
Richardson, TX 75082-9705

Phone

(469) 471-1988

NPI assigned

Mar 25, 2016

Organization subpart

No

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

Authorized official

Name

Uzma Waheed Khan, RD LDNPI 1649459405

Title

Dietitian

Phone

(469) 471-1988

Specialties & licenses 2

Addresses

Other names 1

• UP4 Nutrition Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Uzma Waheed Khan, MS; RD; LD

  • Registered Dietitian
  • Allen, TX
  • NPI 1649459405

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1942662283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 BOULDER DRIVE",
            "city": "PARKER",
            "state": "TX",
            "postal_code": "75002",
            "telephone_number": "469-471-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 SPECTRUM BLVD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750829705",
            "telephone_number": "469-471-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UP4 NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "UZMA",
        "authorized_official_middle_name": "WAHEED",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "469-471-1988",
        "authorized_official_credential": "RD LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "DT07722",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UP4 Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• University of Texas Dallas
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• Marcia Breithaupt Upson, NP
• Urocentric
• Haley Urschel
• USA Diagnostics LLC

• Registered Dietitian in Richardson, TX
• Providers in Richardson, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.