Kelly Burgess, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

252072 Issued in KY

Practice address

1 Sparks Ave
Jamestown, KY 42629-2449

Phone

(270) 343-2101

NPI assigned

Sep 5, 2022

Last updated

Sep 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1134840564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 CAVE MILL STATION BLVD APT 922",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421046407",
            "telephone_number": "615-815-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPARKS AVE",
            "city": "JAMESTOWN",
            "state": "KY",
            "postal_code": "426292449",
            "telephone_number": "270-343-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3740 Old Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423031727",
            "country_code": "US",
            "telephone_number": "270-684-7259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 Glenview Dr",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421413424",
            "country_code": "US",
            "telephone_number": "270-651-8332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "718 Goodwin Ln",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "427541400",
            "country_code": "US",
            "telephone_number": "270-259-4036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KELLY",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "252072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Jamestown, KY
• Providers in Jamestown, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.