GRAND TRAVERSE NUTRITION, LLC (NPI# 1396160388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396160388 |
| Entity Type | Organization |
| Organization Name | GRAND TRAVERSE NUTRITION, LLC |
| Practice Address |
800 Cottageview Dr Suite 1076 Traverse City MI 49684-2616 |
| Mailing Address |
Po Box 6263 Traverse City MI 49696-6263 |
| Practice Telephone | 2316321522 |
| Mailing Telephone | 2316321522 |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |
| Authorized Official Name | MS. MIRANDA MONROE (MEMBER/OWNER) |
| Authorized Official Telephone | 2316321522 |
| Authorized Official Credential | RDN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RDN - COMMISSION DIETETIC REGISTRATION | 851200 | 01 |
| Street Address |
800 COTTAGEVIEW DR SUITE 1076 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932589546 | Sentience Integrated Wellness Pllc | Social Worker | 800 Cottageview Dr, Suite 1074, Traverse City, MI 49684-2616 | 2015-06-09 |
| 1043607278 | Daniel Herd | Social Worker | 800 Cottageview Dr, Suite 1074, Traverse City, MI 49684-2616 | 2015-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| 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 |
|---|---|---|---|---|
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265089361 | Lacy Marie Amor | Dietitian, Registered | 766 Indian Trail Blvd, Traverse City, MI 49686-3567 | 2019-08-22 |
| 1790844835 | Sandra Mcsweeney | Dietitian, Registered | 5015 N Royal Dr Suite B, Traverse City, MI 49684 | 2006-12-06 |
| 1619532900 | Brittany Miller | Dietitian, Registered | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-05-02 |
| 1407324601 | Amy Rasmussen | Dietitian, Registered | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2018-11-06 |
| 1417432444 | Melissa Ann Goodchild | Dietitian, Registered | 1105 Sixth St, Traverse City, MI 49684-2345 | 2018-09-25 |
| 1972030864 | Chelsea Renell Fitzpatrick | Dietitian, Registered | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2017-05-22 |
| 1982056776 | Emilie Klemptner | Dietitian, Registered | 1105 Sixth St, Traverse City, MI 49684-2349 | 2016-07-06 |
| 1427402775 | Laura Mccain | Dietitian, Registered | 1105 Sixth St, Munson Medical Center, Food & Nutrition, Traverse City, MI 49684-2349 | 2016-04-22 |
| 1770956104 | Elizabeth Hyek-gotts | Dietitian, Registered | 415 Munson Ave, Ste 103, Traverse City, MI 49686-3059 | 2015-11-06 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.