ENDOBIOGENIC INTEGRATIVE MEDICAL CENTER
NPI 1821239781
Nutritionist in Pocatello, ID

Active since March 23, 2009
357 W CENTER ST STE 204, POCATELLO, ID 83204(208) 478-8400(208) 232-6018 Get Directions Write a Review

NPPES record last updated: March 23, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Nutritionist

About ENDOBIOGENIC INTEGRATIVE MEDICAL CENTER

This page provides the complete NPI Profile along with additional information for Endobiogenic Integrative Medical Center, a provider established in Pocatello, Idaho operating as a Nutritionist. The healthcare provider is registered in the NPI registry with number 1821239781 assigned on March 2009. The practitioner's primary taxonomy code is 133N00000X. The provider is registered as an organization and their NPI record was last updated 17 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. Annette Nica Davis C.n. (Administrator)

NPI
1821239781 Verify this NPI
Provider Name
ENDOBIOGENIC INTEGRATIVE MEDICAL CENTER
Entity Type
Organization
Location Address
357 W CENTER ST STE 204 POCATELLO, ID 83204
Location Phone
(208) 478-8400
Location Fax
(208) 232-6018
Mailing Address
357 W CENTER ST STE 204 POCATELLO, ID 83204
Mailing Phone
(208) 478-8400
Mailing Fax
(208) 232-6018
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-23-2009
Last Update Date
03-23-2009
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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

Nutritionist

Taxonomy Code
133N00000X
Type
Dietary & Nutritional Service Providers
License State
ID
Taxonomy Description
A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. ANNETTE NICA DAVIS C.N.

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(208) 478-8400

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821239781, enumerated as an "organization" on March 23, 2009.

The provider is located at 357 W CENTER ST STE 204 POCATELLO, ID 83204 and the phone number is (208) 478-8400.

Nutritionist with taxonomy code 133N00000X.