Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Breanna Pottebaum

Individual provider Registered Dietitian · NPI 1487482857

Breanna Pottebaum is a Registered Dietitian OR Nutrition Professional in West Hollywood, California. Qualified in 2021, 5 years ago. Practices with Nourish, Inc, a 277-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2024
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Practice location Address checks out

944 Palm Ave Apt 5
West Hollywood, CA 90069-4017
Phone: (952) 300-0907
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86154650 (MN)

Record details

NPI number1487482857
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 25, 2024
Last updated in NPPESJuly 25, 2024
Certification dateJuly 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Nourish, Inc. — 277 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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