MEDICARE: JWF NUTRITION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1356749170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JWF NUTRITION, LLC

Provider Business Mailing Address
First Line	:	848 FIRST COLONIAL RD STE B
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6126
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	848 FIRST COLONIAL RD STE B
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6126
Country	:	US
Telephone Number	:	757-422-4728
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ PRESIDENT
Name	:	MR. JAMES WHITE
Credential	:
Telephone Number	:	757-749-8469

Provider Enumeration Date	:	12/10/2014
Last Update Date	:	09/24/2025

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