Active NPI
Kimerli Ann Monroe, R. D., L.D.
- Registered Dietitian
- Jasper, TX
National Provider Identifier
1134419062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT02513
- Practice address
- 797 W Gibson St
Jasper, TX 75951-4973 - Phone
- (409) 384-5713
- Fax
- (409) 384-6529
- NPI assigned
- Apr 12, 2011
- 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 | DT02513 | TX | Primary |
Addresses
Primary practice location
797 W Gibson St
Jasper, TX 75951-4973
Mailing address
PO Box 518
Jasper, TX 75951-0007
Phone (409) 384-6718
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 |
|---|---|---|---|
| DT02513 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1134419062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 518",
"city": "JASPER",
"state": "TX",
"postal_code": "759510007",
"telephone_number": "409-384-6718",
"fax_number": "409-384-6529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "797 W GIBSON ST",
"city": "JASPER",
"state": "TX",
"postal_code": "759514973",
"telephone_number": "409-384-5713",
"fax_number": "409-384-6529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONROE",
"first_name": "KIMERLI",
"middle_name": "ANN",
"credential": "R. D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-12",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT02513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jasper, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.