EARTHSOUL NUTRITION THERAPY PLLC — NPI 1124881545 (Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric in PORTLAND, ME)

CMS-1500 Box 24J / 33a • NPI

1124881545

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

133VN1004X (CMS 71)

Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric

Box 32 Service Location & ZIP+4

15 BRAMHALL ST APT 4, PORTLAND, ME, 04102-3122

✓ 9-Digit EDI 837 ZIP+4 (04102-3122)

Practice Phone & Referral Fax

(603) 793-3221

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1124881545 (EARTHSOUL NUTRITION THERAPY PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1124881545` (NPI-2 Organization / Facility)
Provider / Legal Name	EARTHSOUL NUTRITION THERAPY PLLC
Plain-English Specialty	Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric NUCC Code: `133VN1004X` (Dietitian, Registered, Nutrition, Pediatric)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	15 BRAMHALL ST APT 4, PORTLAND, ME, 04102-3122
Practice Telephone / Fax	Tel: (603) 793-3221
Administrative Mailing Address	15 BRAMHALL ST APT 4, PORTLAND, ME, 04102-3122
Enumeration & Last Sync	Enumerated: 2024-01-31 \| CMS Record Updated: 2024-12-05
Authorized Official	ALEXANDRA FIERROS (Co-Founder)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

15 BRAMHALL ST APT 4, PORTLAND, ME, 04102-3122

🗺️ Open in Google Maps 🏥 More Providers in PORTLAND

🔒 Are you EARTHSOUL NUTRITION THERAPY PLLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (133VN1004X)

What Does Taxonomy Code 133VN1004X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 133VN1004X translates to:
"Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 71 (Registered Dietitian or Nutrition Professional)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Dietitian, Registered, Nutrition, Pediatric for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EARTHSOUL NUTRITION THERAPY PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`133V00000X` — Dietitian, Registered Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered	State: N/A \| License: `Verified` \| Primary: Secondary
`133VN1004X` — Dietitian, Registered, Nutrition, Pediatric Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered, Nutrition, Pediatric	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

EARTHSOUL NUTRITION THERAPY PLLC (NPI #1124881545)