Santiago Capetillo Gutierrez, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

6336 Darlington Ave
College Station, TX 77845-2214

Phone

(936) 349-6546

NPI assigned

Jun 21, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Santiago Capetillo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Renegade Rd LLC

  • Registered Dietitian
  • Georgetown, TX
  • NPI 1467282673

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1104501535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6336 DARLINGTON AVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778452214",
            "telephone_number": "936-349-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 DARLINGTON AVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778452214",
            "telephone_number": "936-349-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPETILLO GUTIERREZ",
        "first_name": "SANTIAGO",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANTIAGO",
            "last_name": "CAPETILLO",
            "credential": "MS, RD, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary A. Campise, LMT
• Cancer Physicians Associated, P.a.
• Amber Leeann Candelaria, LVN
• Teresa Mae Cannon, LMSW
• Phuonguyen Pham Cantrell, OTR
• Sarah Caplick
• Caprock Urgent Care, LLC
• Michael Caraway, M.D.
• Cardiovascular Specialists of Texas, P.a.
• Scott David Cardone, MD

• Registered Dietitian in College Station, TX
• Providers in College Station, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.

Verify at the official NPI Registry.