=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235059965
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GROWING MINDS NUTRITION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2026
-----------------------------------------------------
Last Update Date | 07/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1130 TEN ROD RD STE C104
-----------------------------------------------------
City | NORTH KINGSTOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02852-4127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-234-6111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13 KING ARTHUR DR
-----------------------------------------------------
City | WEST KINGSTON
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02892-1089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-234-6111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MEGAN B MARTIN
-----------------------------------------------------
Credential | RD
-----------------------------------------------------
Telephone | 401-234-6111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------