Active NPI
Kevin Wilson
- Registered Dietitian
- Danville, VA
National Provider Identifier
1104611920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L006913
- Practice address
- 325 Piedmont Dr Ste 2005
Danville, VA 24540-4175 - Phone
- (434) 710-4210
- NPI assigned
- Apr 11, 2025
- Last updated
- Apr 11, 2025
- Sex
- Unspecified or another gender identity
- 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 | L006913 | NC | Primary |
Addresses
Primary practice location
325 Piedmont Dr Ste 2005
Danville, VA 24540-4175
Mailing address
325 Piedmont Dr Ste 2005
Danville, VA 24540-4175
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 |
|---|---|---|---|
| L006913 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1104611920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 PIEDMONT DR STE 2005",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245404175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 PIEDMONT DR STE 2005",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245404175",
"telephone_number": "434-710-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-04-11",
"last_updated": "2025-04-11",
"certification_date": "2025-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L006913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.