Active NPI
Kristen Avera, RD, LD, CDCES
- Registered Dietitian
- Atlanta, GA
National Provider Identifier
1093313090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD005269
- Practice address
- 1380 W Marietta St NW
Atlanta, GA 30318-4974 - Phone
- (404) 981-6533
- NPI assigned
- Oct 12, 2020
- Last updated
- May 22, 2026
- Sex
- Female
- Sole proprietor
- No
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LD005269 | Other | GA | GEORGIA PROFESSIONAL LICENSING BOARD |
| 86032146 | Other | COMMISSION ON DIETETIC REGISTRATION | |
| 22200347 | Other | CERTIFICATION 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.