Active NPI
Kathryn Goldberg
- Registered Dietitian
- Henderson, NV
National Provider Identifier
1134925381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1013469
- Practice address
- 2528 Silver Beach Dr
Henderson, NV 89052-2664 - Phone
- (702) 573-7325
- NPI assigned
- Feb 19, 2025
- Last updated
- Feb 19, 2025
- 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 | 1013469 | NV | Primary |
Addresses
Primary practice location
2528 Silver Beach Dr
Henderson, NV 89052-2664
Mailing address
2528 Silver Beach Dr
Henderson, NV 89052-2664
Phone (702) 573-7325
Other practice location 1
1150 J St Unit 818
San Diego, CA 92101-7256
Phone (702) 573-7325
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 |
|---|---|---|---|
| 1013469 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1134925381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2528 SILVER BEACH DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522664",
"telephone_number": "702-573-7325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2528 SILVER BEACH DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522664",
"telephone_number": "702-573-7325"
}
],
"practiceLocations": [
{
"address_1": "1150 J St Unit 818",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921017256",
"country_code": "US",
"telephone_number": "702-573-7325",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLDBERG",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-19",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "1013469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.