Healthcare Provider Details

I. General information

NPI: 1417875717
Provider Name (Legal Business Name): JAMES BURNS NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7333 BERKSHIRE DOWNS DR
RALEIGH NC
27616-5637
US

IV. Provider business mailing address

7333 BERKSHIRE DOWNS DR
RALEIGH NC
27616-5637
US

V. Phone/Fax

Practice location:
  • Phone: 631-338-3701
  • Fax:
Mailing address:
  • Phone: 631-338-3701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JAMES BURNS
Title or Position: MANAGING MEMBER
Credential: MS, RD
Phone: 631-338-3701