Active NPI
Kelly Lynne Peper, RD
- Registered Dietitian
- Tempe, AZ
National Provider Identifier
1104540491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1051673
- Practice address
- 1840 E Broadway Rd
Tempe, AZ 85282-1614 - Phone
- (602) 243-7277
- NPI assigned
- Sep 29, 2022
- 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 | 1051673 | AZ | Primary |
Addresses
Primary practice location
1840 E Broadway Rd
Tempe, AZ 85282-1614
Mailing address
832 E Powell Way
Chandler, AZ 85249-3012
Phone (480) 296-9633
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1051673 | AZ | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1104540491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "832 E POWELL WAY",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852493012",
"telephone_number": "480-296-9633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 E BROADWAY RD",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852821614",
"telephone_number": "602-243-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEPER",
"first_name": "KELLY",
"middle_name": "LYNNE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-29",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "1051673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.