Great Basin Nutrition LLC
NPI 1053883520 · Registered Dietitian · Carson City, NV
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Great Basin Nutrition LLC is a Registered Dietitian organization in Carson City, NV (NPI 1053883520).
Provider details
- NPI number
- 1053883520
- Entity type
- Organization
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Jodi Pettersen, Owner(775) 720-3490
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-12-21
- Last updated
- 2018-12-21
Frequently asked questions
- What is Great Basin Nutrition LLC's NPI number?
- Great Basin Nutrition LLC's National Provider Identifier (NPI) is 1053883520, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Basin Nutrition LLC?
- Great Basin Nutrition LLC is classified in the NPPES registry as Registered Dietitian (Dietary & Nutritional Service Providers).
- Where is Great Basin Nutrition LLC located?
- Great Basin Nutrition LLC's practice location on file with NPPES is 783 Basque Way Ste 103, Carson City, NV 89706-7981.
- What is Great Basin Nutrition LLC's phone number?
- The practice phone number listed in the NPPES registry for Great Basin Nutrition LLC is (775) 720-3490.
- Does Great Basin Nutrition LLC accept Medicare?
- Great Basin Nutrition LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Great Basin Nutrition LLC?
- The authorized official listed on Great Basin Nutrition LLC's NPPES record is Jodi Pettersen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Basin Nutrition LLC's NPI active?
- Yes — Great Basin Nutrition LLC's NPI (1053883520) is active in the NPPES registry as of the last update on 2018-12-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.