NPI age
17 years
Enumerated 2009-05-25
● Active Type 2 · Organization
Nutrisource Nutritional Services
Nutrisource Nutritional Services is 1 of 1653 dietitian, registered organizations in Georgia.
Primary specialty
Dietitian, Registered
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Giczewski
Owner
Last NPPES update
2009-05-25
Source: monthly bulk 2026-05
How this organization compares
Across 1653 active dietitian, registered providers in Georgia.
NPI age
17 years
↑ 10 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-05Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
3226 Hampton Ave Ste F
Brunswick, GA 315204252
Mailing address
620 Sea Island Rd, Pmb 273
St Simons Island, GA 315221767
Authorized official
Lauren A Giczewski, R.D., L.D, C.P.T.
Owner
📞 9122227755
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Whitney McConnell Podiatrist NPI 1902248883
- Jennifer Nicholson, RD, LD/N, MSH Dietitian, Registered NPI 1346523297
- Elizabeth Ryland, PH.D. Psychologist NPI 1952636953
Specialties
-
Dietitian, Registered PrimaryA Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 931505 | COMMISSION ON DIETETIC REGISTRATION |
| 01 | 00931505 | AMERICAN DIETETIC ASSOCIATION |
| 01 (GA) | LD002579 | LICENSED DIETITIAN |
| 01 | T118230 | AMERICAN COUNCIL ON EXERCISE PERSONAL TRAINER |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.