Individual provider Active NPI

Krystyn Parks, RD

  • Registered Dietitian
  • Anaheim, CA
National Provider Identifier
1023444080
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1001216 Issued in CA
Practice address
3440 E la Palma Ave
Anaheim, CA 92806-2020
Phone
(714) 644-6750
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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 1001216 CA Primary

Addresses

Primary practice location

3440 E la Palma Ave
Anaheim, CA 92806-2020

Mailing address

13211 Myford Rd
1332
Tustin, CA 92782-9153
Phone (925) 699-4453

Other names 1

  • Krystyn Landrum Former name

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
1001216CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1023444080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13211 MYFORD RD",
            "address_2": "1332",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829153",
            "telephone_number": "925-699-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062020",
            "telephone_number": "714-644-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KRYSTYN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1001216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTYN",
            "last_name": "LANDRUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.