Individual provider Active NPI

Kristen Avera, RD, LD, CDCES

  • Registered Dietitian
  • Atlanta, GA
National Provider Identifier
1093313090
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD005269 Issued in GA
Practice address
1380 W Marietta St NW
Atlanta, GA 30318-4974
Phone
(404) 981-6533
NPI assigned
Oct 12, 2020
Last updated
May 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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 LD005269 GA Primary

Addresses

Primary practice location

1380 W Marietta St NW
Atlanta, GA 30318-4974

Mailing address

1524 Deerwood Dr
Decatur, GA 30030-4516

Other identifiers 3

IdentifierTypeStateIssuer
LD005269OtherGAGEORGIA PROFESSIONAL LICENSING BOARD
86032146OtherCOMMISSION ON DIETETIC REGISTRATION
22200347OtherCERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1093313090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 DEERWOOD DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 W MARIETTA ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303184974",
            "telephone_number": "404-981-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERA",
        "first_name": "KRISTEN",
        "credential": "RD, LD, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD005269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA PROFESSIONAL LICENSING BOARD",
            "identifier": "LD005269",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86032146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION",
            "identifier": "22200347",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; 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.