Individual provider Active NPI

Matthew Christopher Bertoldie, RD

  • Registered Dietitian
  • Springfield, MO
National Provider Identifier
1164336244
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2024028058 Issued in MO
Practice address
3020 S Sagamont Ave Apt D18
Springfield, MO 65807-4596
Phone
(417) 241-1855
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2024028058 MO Primary

Addresses

Primary practice location

3020 S Sagamont Ave Apt D18
Springfield, MO 65807-4596

Mailing address

3020 S Sagamont Ave Apt D18
Springfield, MO 65807-4596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1164336244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 S SAGAMONT AVE APT D18",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S SAGAMONT AVE APT D18",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074596",
            "telephone_number": "417-241-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLDIE",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2024028058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.