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.

OrganizationActiveAccepts Medicare

Great Basin Nutrition LLC

NPI 1053883520 · Registered Dietitian · Carson City, NV

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

Practice location

783 Basque Way Ste 103

Carson City, NV 89706-7981

Phone: (775) 720-3490

Fax: (775) 245-2867

Street-level locationGet directions

More NV providers

Mailing address

783 Basque Way Ste 103

Carson City, NV 89706-7981

Specialties & taxonomies

Registered DietitianPrimary133V00000X
Dietary & Nutritional Service Providers

Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Profile Score

Established profile(67/100 index)

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.

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.

Provider details

Practice location

Mailing address

Specialties & taxonomies

Profile Score

Registry dates

Frequently asked questions

Specialties & taxonomies

Profile Score

Frequently asked questions