Indigenous Nutritionist

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

48007672 Issued in NY

Legal business name

INDIGENOUS NUTRITIONIST

Practice address

538 E 85TH St
5B
New York, NY 10028-7447

Phone

(207) 344-7115

NPI assigned

Sep 14, 2015

Organization subpart

No

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

Authorized official

Name

Kelly Jacqueline Ahearn, RDN

Title

Owner

Phone

(207) 344-7115

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.

• Kelly Jacqueline Zinnoury, RDN CDN

  • Registered Dietitian
  • New York, NY
  • NPI 1134593171

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1962870436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 E 85TH ST",
            "address_2": "5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287447",
            "telephone_number": "207-344-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 E 85TH ST",
            "address_2": "5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287447",
            "telephone_number": "207-344-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGENOUS NUTRITIONIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "AHEARN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-344-7115",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "48007672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madhuri Indaram, DO
• Independence at Home - Physician House Calls for the Homebound, P.C.
• Independent Spine Surgeons of New York
• Michelle Akins Inderwies, OTR
• Indie Health Inc.
• Indigo Chiropractic Wellness PC
• Indigo Psychotherapy LCSW PC
• Indira Kairam, MD P.C.
• Individualized Psychotherapy Mental Health Counseling PLLC
• Joanne A Indiviglio

• Registered Dietitian in New York, NY
• Providers in New York, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.