Provider Demographics
NPI:1811789332
Name:PRIORITY DIETETICS LLC
Entity type:Organization
Organization Name:PRIORITY DIETETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:240-751-7737
Mailing Address - Street 1:424 WASHINGTON ST STE 9
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-6790
Mailing Address - Country:US
Mailing Address - Phone:240-751-7737
Mailing Address - Fax:
Practice Address - Street 1:424 WASHINGTON ST STE 9
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6790
Practice Address - Country:US
Practice Address - Phone:240-751-7737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty