Nutricoachaz LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NUTRICOACHAZ LLC

Practice address

9075 S Parkside LN E
Buckeye, AZ 85326-2448

Phone

(623) 258-2608

NPI assigned

Mar 9, 2020

Organization subpart

No

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

Authorized official

Name

Yvonne Roehr, MS, RDN

Title

Ceo

Phone

(623) 258-2608

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1942835103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853260030",
            "telephone_number": "623-258-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9075 S PARKSIDE LN E",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853262448",
            "telephone_number": "623-258-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRICOACHAZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "ROEHR",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-258-2608",
        "authorized_official_credential": "MS, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1336797471",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BUCKEYE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9075 S Parkside Ln E",
            "city": "Buckeye",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853262448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Dietitian in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.