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NOURISHING WELLNESS INC
NPI 1336321520
Internal Medicine in Redondo Beach, CA

Active since November 29, 2007
819 N HARBOR DR, SUITE 310, REDONDO BEACH, CA 90277(310) 373-7830(310) 373-7840 Get Directions Write a Review

NPPES record last updated: April 15, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nourishing Wellness Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOURISHING WELLNESS INC (NPI 1336321520) is a healthcare organization registered as an internal medicine in Redondo Beach, California and active in the NPI registry since November 2007. The organization lists Allen Peters, Owner, as its authorized official.

NPPES Registry Identity

NPI1336321520
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameNOURISHING WELLNESS INC
Location Address819 N HARBOR DR, SUITE 310Redondo Beach, CA 90277-2006
Mailing Address819 N Harbor Dr, Suite 310Redondo Beach, CA 90277-2006 · (310) 373-7830 · Fax (310) 373-7840
Phone(310) 373-7830
Fax(310) 373-7840
Organization SubpartNo
Authorized OfficialAllen PetersOwner · (310) 373-7830
Enumeration DateNovember 29, 2007
Last NPPES UpdateApril 15, 2020
NPPES CertifiedApril 15, 2020
✔ NPI 1336321520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G16945
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
819 N HARBOR DR, Redondo Beach, CA 90277
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nourishing Wellness Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20061011000486Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Nourishing Wellness Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Allen Peters, M.D.
Preventive Medicine
NPI 1881608909
819 N HARBOR DR SUITE 310
Redondo Beach, CA 90277
(310) 373-7830
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nourishing Wellness Inc's NPI number?

The NPI number for Nourishing Wellness Inc is 1336321520. It was assigned to this organization in the NPPES registry on November 29, 2007.

Where is Nourishing Wellness Inc located?

Nourishing Wellness Inc is located at 819 N Harbor Dr Suite 310, Redondo Beach, CA 90277. The listed phone number is (310) 373-7830.

What is Nourishing Wellness Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nourishing Wellness Inc enrolled in Medicare?

Yes. Nourishing Wellness Inc is registered in the Medicare PECOS enrollment system.

When is Nourishing Wellness Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Nourishing Wellness Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Preventive Medicine) reassigns their Medicare billing to Nourishing Wellness Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Nourishing Wellness Inc was last updated on April 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.