Provider Demographics
NPI:1497060123
Name:WEB-RD, LLC
Entity Type:Organization
Organization Name:WEB-RD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NODVIN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:404-414-1112
Mailing Address - Street 1:8343 ROSWELL RD # 323
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2810
Mailing Address - Country:US
Mailing Address - Phone:404-414-1112
Mailing Address - Fax:213-286-0025
Practice Address - Street 1:5485 LINGER LONGER RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9091
Practice Address - Country:US
Practice Address - Phone:404-414-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001144133VN1006X
133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty