Active NPI
Kelly Marie Snead, RD
- Registered Dietitian
- Cumming, GA
National Provider Identifier
1093406209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD004795
- Practice address
- 1200 Northside Forsyth Dr
Cumming, GA 30041-7659 - Phone
- (770) 844-3272
- NPI assigned
- May 18, 2023
- Last updated
- May 18, 2023
- 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 | LD004795 | GA | Primary |
Addresses
Primary practice location
1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Mailing address
120 Concord Trce
Alpharetta, GA 30005-4383
Phone (470) 510-6119
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 |
|---|---|---|---|
| LD004795 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1093406209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 CONCORD TRCE",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300054383",
"telephone_number": "470-510-6119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 NORTHSIDE FORSYTH DR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417659",
"telephone_number": "770-844-3272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNEAD",
"first_name": "KELLY",
"middle_name": "MARIE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD004795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.