Active NPI
Kimberly K. Dickson, RD, CDE
- Registered Dietitian
- Mesquite, TX
National Provider Identifier
1114362308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT06169
- Practice address
- 1575 I-30
Mesquite, TX 75150-6905 - Phone
- (469) 800-2800
- Fax
- (469) 800-2801
- NPI assigned
- May 2, 2013
- 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 | DT06169 | TX | Primary |
Addresses
Primary practice location
1575 I-30
Mesquite, TX 75150-6905
Mailing address
1575 I-30
Mesquite, TX 75150-6905
Phone (469) 800-2800
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 |
|---|---|---|---|
| DT06169 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1114362308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 I-30",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751506905",
"telephone_number": "469-800-2800",
"fax_number": "469-800-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 I-30",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751506905",
"telephone_number": "469-800-2800",
"fax_number": "469-800-2801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "KIMBERLY",
"middle_name": "K.",
"credential": "RD, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-02",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT06169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.