Nutrition Support Solutions LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NUTRITION SUPPORT SOLUTIONS LLC

Practice address

55 Meadowfield Dr
Southampton, PA 18966-3043

Phone

(267) 625-6853

Fax

(833) 613-2703

NPI assigned

Sep 16, 2024

Organization subpart

No

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

Authorized official

Name

Dominique Johnston, MS, RD, LDNNPI 1184324386

Title

Owner, Registered Dietitian

Phone

(267) 625-6853

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dominique Showmaker Johnston, RD LDN

  • Registered Dietitian
  • Southampton, PA
  • NPI 1184324386

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1972330876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MEADOWFIELD DR",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MEADOWFIELD DR",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663043",
            "telephone_number": "267-625-6853",
            "fax_number": "833-613-2703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION SUPPORT SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER, REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "267-625-6853",
        "authorized_official_credential": "MS, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Southampton, PA
• Providers in Southampton, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.