Individual provider Active NPI

Audrey Kessler, RD

  • Registered Dietitian
  • Johnson City, TN
National Provider Identifier
1063763613
Registry record updated Sep 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2503 Issued in TN
Practice address
422 W Locust St
Johnson City, TN 37604-6730
Phone
(423) 202-3981
NPI assigned
Sep 23, 2012
Last updated
Sep 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2012

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 2503 TN Primary

Addresses

Primary practice location

422 W Locust St
Johnson City, TN 37604-6730

Mailing address

422 W Locust St
Johnson City, TN 37604-6730

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
2503TNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1348358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348358400000",
    "number": "1063763613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 W LOCUST ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W LOCUST ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046730",
            "telephone_number": "423-202-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "AUDREY",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-23",
        "last_updated": "2012-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2012; 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.