Annette Karin Anderson, MS, RD, LD, LMT

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT4158 Issued in TX

Practice address

2100 N State Highway 360
Suite 1106a
Grand Prairie, TX 75050-1011

Phone

(817) 899-5450

NPI assigned

Jan 20, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1174828206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 N COLLINS ST",
            "address_2": "SUITE 433402",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760112849",
            "telephone_number": "817-899-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N STATE HIGHWAY 360",
            "address_2": "SUITE 1106A",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501011",
            "telephone_number": "817-899-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANNETTE",
        "middle_name": "KARIN",
        "credential": "MS, RD, LD, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT4158",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT40972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amiable Care of HCS
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• Ams Kwarteng Services LLC
• Anchorage Medical Equipment & Supplies LLC
• Andrea Jane Anderson
• Donesha Alissa Anderson
• Jeffrey Allan Anderson, LPC
• Marshall Anderson, MS LAT ATC
• Michael D. Anderson, D.C.
• Roxanne Anderson, LM, CPM

• Registered Dietitian in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.