Kaitlyn Greb, RDLD – Registered Dietitian

Key facts

NPI: 1164949541
Entity type: Individual (NPI type 1)
Primary specialty: Registered Dietitian 133V00000X
License: DT84769 (TX)
Practice address: 3023 Perryton Pkwy Ste 101
Pampa, TX 79065-2817
Phone: (806) 665-0801
Fax: (806) 665-8503
NPI assigned: Aug 25, 2017
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Milestone Mt, LLC Non-emergency Medical Transport (VAN) · Pikesville, MD · NPI 1467382846

NPD

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
DT84769	TX	MD	Registered Dietitian

Practice roles

Organization	Specialty	Status	New patients
Milestone Mt, LLC		Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Registered Dietitian	133V00000X	DT84769	TX	Yes

Addresses

Primary practice location

3023 Perryton Pkwy Ste 101
Pampa, TX 79065-2817

Mailing address

PO Box 1391
Panhandle, TX 79068-1391
Phone (479) 518-0711

Other identifiers

Identifier	Type	State	Issuer
DT84769	Other	TX	LICENSE NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 25, 2017.

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1164949541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1391",
            "city": "PANHANDLE",
            "state": "TX",
            "postal_code": "790681391",
            "telephone_number": "479-518-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 PERRYTON PKWY STE 101",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652817",
            "telephone_number": "806-665-0801",
            "fax_number": "806-665-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREB",
        "first_name": "KAITLYN",
        "credential": "RDLD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT84769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DT84769",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pampa, TX

All providers in Pampa, TX · Registered Dietitian in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.