GREAT BASIN NUTRITION LLC
NPI 1053883520
Dietitian, Registered in Carson City, NV
NPI Status: Active since December 21, 2018
Contact Information
783 BASQUE WAY STE 103
CARSON CITY, NV
ZIP 89706
Phone: (775) 720-3490
Fax: (775) 245-2867
- Organization
- Dietitian, Registered
- Accepts Insurance
- CLIA Number: 29D1080149
- CLIA Cert. Type: Other - O/P IMAGING CENTER
- CLIA Exp. Date: 02-13-2026
About GREAT BASIN NUTRITION LLC
This page provides the complete NPI Profile along with additional information for Great Basin Nutrition Llc, a provider established in Carson City, Nevada operating as a Dietitian, Registered. The healthcare provider is registered in the NPI registry with number 1053883520 assigned on December 2018. The practitioner's primary taxonomy code is 133V00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Jodi Pettersen Rdn, Ld (Owner)
- NPI
- 1053883520
- Provider Name
- GREAT BASIN NUTRITION LLC
- Entity Type
- Organization
- Location Address
- 783 BASQUE WAY STE 103 CARSON CITY, NV 89706
- Location Phone
- (775) 720-3490
- Location Fax
- (775) 245-2867
- Mailing Address
- 783 BASQUE WAY STE 103 CARSON CITY, NV 89706
- Mailing Phone
- (775) 720-3490
- Mailing Fax
- (775) 245-2867
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-21-2018
- Last Update Date
- 12-21-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dietitian, Registered
- Taxonomy Code
- 133V00000X
- Type
- Dietary & Nutritional Service Providers
- Taxonomy Description
- A 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 applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 29D1080149
- Facility Type
- Other - O/P IMAGING CENTER
- Certificate Effective Date
- February 14, 2024
- Certificate Expiration Date
- February 13, 2026
- Laboratory Director
- DANIEL KIRKHAM
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Great Basin Nutrition Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053883520, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053883520, enumerated as an "organization" on December 21, 2018.
The provider is located at 783 BASQUE WAY STE 103 CARSON CITY, NV 89706 and the phone number is (775) 720-3490.
Dietitian, Registered with taxonomy code 133V00000X.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health. Please consult your insurance carrier or call the provider to verify.
