Intentful Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

INTENTFUL NUTRITION LLC

Practice address

205 E Benson Blvd Ste 501
Anchorage, AK 99503-4019

Phone

(315) 663-1028

NPI assigned

Mar 9, 2022

Last updated

May 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Brooke Busa Czarnecki, RDN, LDNPI 1184239626

Title

Registered Dietitian Nutritionist

Phone

(315) 663-1028

Specialties & licenses 1

Addresses

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.

• Brooke Busa Czarnecki, RDN

  • Registered Dietitian
  • Columbus, GA
  • NPI 1184239626

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1942957816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7404 METZGER AVE UNIT A",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995062020",
            "telephone_number": "315-663-1028",
            "fax_number": "907-215-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E BENSON BLVD STE 501",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034019",
            "telephone_number": "315-663-1028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7404 Metzger Ave Unit A",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "995062020",
            "country_code": "US",
            "telephone_number": "315-663-1028",
            "fax_number": "907-215-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTENTFUL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "CZARNECKI",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "BUSA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN NUTRITIONIST",
        "authorized_official_telephone_number": "315-663-1028",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Registered Dietitian in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.