Christina Koon, MS, RD, CSSD, LRD

Primary specialty

Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X

License

86058329 Issued in SC

Practice address

508 Brasstown CT
Pendleton, SC 29670-1877

Phone

(616) 460-7914

NPI assigned

Oct 3, 2023

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1043090517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 BRASSTOWN CT",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701877",
            "telephone_number": "616-460-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 BRASSTOWN CT",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701877",
            "telephone_number": "616-460-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "CHRISTINA",
        "credential": "MS, RD, CSSD, LRD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "SC",
            "license": "86058329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Quarterman Johnson, PHARMACIST
• Shannon Marie Johnson, NP-C
• Audrey SG Jones, MD
• Janice Marie Kendrick
• Baylee Klindworth
• Namour Lamonica, LPC-A
• Angela Jean Langdale, RN
• Amanda Patricia Leibovitz, PHD, LPC, LMHC, CMPC
• Patrick G Lollis, MD
• Heath Jackson Major, M.S., ATC

• Sports Dietetics Nutrition Registered Dietitian in Pendleton, SC
• Providers in Pendleton, SC by specialty
• Sports Dietetics Nutrition Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.