NUTRITION 411 BEVERLY FORD RD LD LLC (NPI# 1225220866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225220866 |
| Entity Type | Organization |
| Organization Name | NUTRITION 411 BEVERLY FORD RD LD LLC |
| Practice Address |
2425 Williams St Augusta GA 30904-6127 |
| Practice Telephone | 7065891582 |
| Mailing Telephone | 7065891582 |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |
| Authorized Official Name | BEVERLY FORD (OWNER) |
| Authorized Official Telephone | 7065891582 |
| Authorized Official Credential | RD LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1005X |
Dietitian, Registered Specialization: Nutrition, Renal |
000488 | GA | Dietary & Nutritional Service Providers |
| Street Address |
2425 WILLIAMS ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 133VN1005X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Renal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962826560 | Nikole Larson | Dietitian, Registered | 1719 Magnolia Way, Augusta, GA 30909-9482 | 2014-02-18 |
| 1861695082 | Beverly Bray Ford | Dietitian, Registered | 1511 Anthony Rd, Augusta, GA 30904-4821 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265839 | Mina Xia | Dietitian, Registered | 7007 Kingswood Run Dr, Atlanta, GA 30340-1865 | 2020-11-03 |
| 1053979690 | Vanessa Lynn Hunt | Dietitian, Registered | 4276 Courtside Dr, Stone Mountain, GA 30083-1292 | 2019-05-30 |
| 1164838173 | Sally Butler Stieghan | Dietitian, Registered | 222 14th St Ne Apt 213, Atlanta, GA 30309-7681 | 2014-07-10 |
| 1265718928 | Practical Wellness LLC | Dietitian, Registered | 889 Stallings Ave Se, Atlanta, GA 30316-2209 | 2011-10-26 |
| 1073793766 | Christy Leigh Roberts | Dietitian, Registered | 190 Calhoun Rd, Griffin, GA 30224-7829 | 2007-11-09 |
| 1487873352 | Cynthia Goudeau | Dietitian, Registered | 1830 Niskey Cove Rd Sw, Atlanta, GA 30331-6339 | 2007-04-25 |
| 1457440786 | Amanda Jo Redden | Dietitian, Registered | 22 Camden Cir, Newnan, GA 30265-5551 | 2006-10-12 |
| 1316057862 | Mary Etta James Gresham | Dietitian, Registered | 5330 Cayuga Ct, Lithonia, GA 30038-1106 | 2006-08-30 |
| 1376579656 | Melissa Ann Krentzman | Dietitian, Registered | 1685 Barfield Run Nw, Atlanta, GA 30318-2778 | 2006-06-25 |
| 1134164346 | Rachel Rene Dartt | Dietitian, Registered | 10218 Madison Dr, Atlanta, GA 30346-2468 | 2006-06-19 |
| 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.