Kaitlin Grace Dorman, M.S., R.D., L.D.N.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND 7527 Issued in FL

Practice address

501 6TH Ave S
St Petersburg, FL 33701-4634

Phone

(727) 767-7204

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlin Grace Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1164886602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 6TH AVENUE SOUTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-767-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "KAITLIN",
        "middle_name": "GRACE",
        "credential": "M.S., R.D., L.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 7527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "CLARK",
            "middle_name": "GRACE",
            "credential": "M.S., R.D,, L.D.N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Donohue, PHARMD
• Mary Elizabeth Donovan, MA, CCC-SLP
• Christopher Donze, M.P.T.
• Donna Maack Dooley, DO
• Brooke Michelle Dorman, PHARMD
• Mary Catherine Dorn
• Donald Schafer Dorr, O.D.
• Dos Beagles, Inc.
• Alexis Marie Dosal, PSYD
• Anna Dotey, LMHC

• Registered Dietitian in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.