Active NPI
Kristy Elaine Neville, RDN.LD
- Registered Dietitian
- Odessa, MO
National Provider Identifier
1083326805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 811705
- Practice address
- 615 W Kirkpatrick St
Odessa, MO 64076-1631 - Phone
- (816) 263-2553
- NPI assigned
- Dec 23, 2022
- Last updated
- Dec 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 811705 | MO | Primary |
Addresses
Primary practice location
615 W Kirkpatrick St
Odessa, MO 64076-1631
Mailing address
615 W Kirkpatrick St
Odessa, MO 64076-1631
Phone (816) 263-2553
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
| License | State | Type | Specialty |
|---|---|---|---|
| 811705 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorative Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
213 W Mason St
#B
Odessa, MO 64076
Phone (417) 848-2262
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1083326805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 W KIRKPATRICK ST",
"city": "ODESSA",
"state": "MO",
"postal_code": "640761631",
"telephone_number": "816-263-2553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 W KIRKPATRICK ST",
"city": "ODESSA",
"state": "MO",
"postal_code": "640761631",
"telephone_number": "816-263-2553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVILLE",
"first_name": "KRISTY",
"middle_name": "ELAINE",
"credential": "RDN.LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-23",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "811705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, MO
- Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #11313)
- Rachael Monteil, COTA
- Junior Scott Munsterman, PT, MPT
- N & R of Odessa LLC (New Haven Living Center)
- Sarah Yaffa Naon, DMD
- Odessa Chiropractic Center
- Odessa Eye Care LLC
- Odessa Family Dental, LLC
- Odessa Family Pharmacy
- Odessa Fire & Rescue Protection District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.