Individual provider Active NPI

Kimberly Detour, RD

  • Registered Dietitian
  • Greenfield, NH
National Provider Identifier
1003113697
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
333 Issued in NH
Practice address
1 Verney Dr
Greenfield, NH 03047-5000
Phone
(603) 547-3311
Fax
(603) 547-3232
NPI assigned
Feb 17, 2011
Last updated
Feb 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 333 NH Primary

Addresses

Primary practice location

1 Verney Dr
Greenfield, NH 03047-5000

Mailing address

1 Verney Dr
Greenfield, NH 03047-5000
Phone (603) 547-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
333NHMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1003113697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VERNEY DR",
            "city": "GREENFIELD",
            "state": "NH",
            "postal_code": "030475000",
            "telephone_number": "603-547-3311",
            "fax_number": "603-547-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VERNEY DR",
            "city": "GREENFIELD",
            "state": "NH",
            "postal_code": "030475000",
            "telephone_number": "603-547-3311",
            "fax_number": "603-547-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETOUR",
        "first_name": "KIMBERLY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.