NUTRITION THERAPY NEW MEXICO LLC (NPI# 1710380910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710380910 |
| Entity Type | Organization |
| Organization Name | NUTRITION THERAPY NEW MEXICO LLC |
| Practice Address |
2185 44th St Ste D Los Alamos NM 87544-1750 |
| Practice Telephone | 5054125983 |
| Mailing Telephone | 5054125983 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | MARY PATRICIA WILLMS (CEO/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5054125983 |
| Authorized Official Credential | RD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LD-0659 | NM | Dietary & Nutritional Service Providers |
| Street Address |
2185 44TH ST STE D |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-1750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| 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 |
|---|---|---|---|---|
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1922304633 | Samia Sibley | Dietitian, Registered | 2025 E Jemez Rd, #120, Los Alamos, NM 87544-1985 | 2011-01-28 |
| 1619449766 | Jordan A Lichthardt | Dietitian, Registered | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2018-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117661 | Jose Luis Guzman Jr. | Dietitian, Registered | 947 Cerrito Dr Apt A, Gallup, NM 87301-5421 | 2020-09-01 |
| 1184237075 | Kelly Ann Gardiner | Dietitian, Registered | 9123 Retablo Rd Nw, Albuquerque, NM 87120-7138 | 2020-08-28 |
| 1356954929 | Hannah Contrucci | Dietitian, Registered | 2920 Carlisle Blvd Ne Ste A1, Albuquerque, NM 87110-2867 | 2020-08-25 |
| 1083227656 | Advanced Nutrition Services, LLC | Dietitian, Registered | 2920 Carlisle Blvd Ne, Ste A1, Albuquerque, NM 87110-2867 | 2020-08-25 |
| 1366051997 | Uma Borkar | Dietitian, Registered | 4425 Ojo Caliente Cir, Las Cruces, NM 88011-4303 | 2020-07-29 |
| 1376152108 | Stephanie Faith Swarthout | Dietitian, Registered | 1401 10th St Ste E, Alamogordo, NM 88310-5012 | 2020-07-28 |
| 1912525445 | Sunrise Nutrition Services, LLC | Dietitian, Registered | 601 C Avenue, Zuni, NM 87327-8732 | 2020-07-10 |
| 1417575267 | Valerie Silver | Dietitian, Registered | 6225 Hannett Ave Ne, Albuquerque, NM 87110-5918 | 2020-07-08 |
| 1295350346 | Amanda Montano | Dietitian, Registered | 9928 Cielito Norte Way Ne, Albuquerque, NM 87122-3222 | 2020-06-15 |
| 1457974420 | Juliet Corley | Dietitian, Registered | 926 Madeira Dr Se, Albuquerque, NM 87108-3618 | 2020-05-25 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
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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.