Active NPI
Kelly Bridget Martinez Pratts, LND
- Registered Dietitian
- Humacao, PR
National Provider Identifier
1093399388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2170
- Practice address
- 14 Calle Miguel Casillas
Humacao, PR 00791-3638 - Phone
- (787) 285-5959
- Fax
- (787) 285-8811
- NPI assigned
- May 12, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 2170 | PR | |
| Registered Dietitian | 133V00000X | 2170 | PR | Primary |
Addresses
Primary practice location
14 Calle Miguel Casillas
Humacao, PR 00791-3638
Mailing address
#501 Calle Azucena Urb El Encanto
Juncos, PR 00777
Phone (787) 428-8176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210728000091 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 2668875782 | Practice locations: Humacao, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2170 | PR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1093399388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "#501 CALLE AZUCENA URB EL ENCANTO",
"city": "JUNCOS",
"state": "PR",
"postal_code": "00777",
"telephone_number": "787-428-8176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 CALLE MIGUEL CASILLAS",
"city": "HUMACAO",
"state": "PR",
"postal_code": "007913638",
"telephone_number": "787-285-5959",
"fax_number": "787-285-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ PRATTS",
"first_name": "KELLY",
"middle_name": "BRIDGET",
"name_prefix": "Mrs.",
"credential": "LND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-12",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "PR",
"license": "2170",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "2170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.