SOUTHERN NUTRITION AND WELLNESS (NPI# 1356828925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356828925 |
| Entity Type | Organization |
| Organization Name | SOUTHERN NUTRITION AND WELLNESS |
| Practice Address |
6073 Luke Rd Ray City GA 31645-2119 |
| Practice Telephone | 2295467585 |
| Mailing Telephone | 2295467585 |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |
| Authorized Official Name | MRS. KATI REBECCA WISE (LICENSED DIETITIAN) |
| Authorized Official Telephone | 2295467585 |
| Authorized Official Credential | MS, RD, LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LD004663 | GA | Dietary & Nutritional Service Providers |
| Street Address |
6073 LUKE RD |
| City | RAY CITY |
| State | GA |
| Zip Code | 31645-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710462114 | Lindsey L Jordan | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1619452018 | Kati Wise | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861027930 | Deborah A Mceady | Contractor | 71 Thigpen Circle, Ray City, GA 31645 | 2020-03-09 |
| 1699299842 | Integrated Telehealth LLC | Internal Medicine | 1523 Old Valdosta Rd Ste B, Ray City, GA 31645 | 2017-07-31 |
| 1548604630 | Ashley Renee Michaels | Behavioral Analyst | 6 W Stanley Rd Ext, Ray City, GA 31645 | 2013-04-19 |
| 1972047140 | Billy Jacobs Jr. | Contractor | 40 Street D, Ray City, GA 31645-2071 | 2016-12-07 |
| 1336635507 | Lacee Nicole Jessup | Contractor | 215 Zeigler Rd, Ray City, GA 31645-6627 | 2018-07-10 |
| 1851917553 | Garland Edward Pendergraph | Pathology | 1974 Old Valdosta Rd, Ray City, GA 31645-7139 | 2020-06-19 |
| 1629313267 | Joyce Ann Deberry | Social Worker | 178 Highway 125, Ray City, GA 31645-7535 | 2012-12-08 |
| 1073859294 | Miranda Moneke Robinson | Social Worker | 95 Oak St, Ray City, GA 31645-8437 | 2012-12-15 |
| 1790923720 | Denise Harrell | Speech-Language Pathologist | 193 Trixie St, Ray City, GA 31645-8612 | 2009-01-29 |
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710462114 | Lindsey L Jordan | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1619452018 | Kati Wise | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305486 | Susanne Mackinnon | Dietitian, Registered | 2678 Hummingbird Dr Nw, Duluth, GA 30096-3998 | 2020-10-26 |
| 1104425107 | Gabriella Schloss | Dietitian, Registered | 2323 Piedmont Rd Ne Apt 2212, Atlanta, GA 30324-3421 | 2020-10-21 |
| 1033717830 | Ariathni Pinacas Powell | Dietitian, Registered | 5761 Hancock Dr, Social Circle, GA 30025-4705 | 2020-10-14 |
| 1467050716 | Louise Brown | Dietitian, Registered | 4075 Cherry Grove Rd, Ball Ground, GA 30107-3295 | 2020-10-09 |
| 1154928513 | Alicia Adams Polk | Dietitian, Registered | 360 Southgate Dr, Locust Grove, GA 30248-4235 | 2020-10-07 |
| 1033716774 | Shannon Busby Bagga | Dietitian, Registered | 1806 Dekalb Ave Ne, Atlanta, GA 30307 | 2020-10-06 |
| 1881291532 | Noelle Yaeger Oleary | Dietitian, Registered | 2591 Birchwood Dr Ne, Atlanta, GA 30305-3819 | 2020-10-06 |
| 1447857149 | Christine Marie Rives | Dietitian, Registered | 4 Skidaway Village Walk, Savannah, GA 31411-2914 | 2020-10-06 |
| 1356948293 | Brittany Mitchell Moment | Dietitian, Registered | 2913 Allie Rd, Greenville, GA 30222-2337 | 2020-10-05 |
| 1003413162 | Deanna Dae Crismon | Dietitian, Registered | 511 Ragsdale Ter, Woodstock, GA 30188-4463 | 2020-10-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.