Kelly L Dickson, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN004679 Issued in PA

Practice address

25 Monument Rd Ste 105
York, PA 17403-5049

Phone

(717) 851-7575

Fax

(717) 812-5154

NPI assigned

Dec 1, 2011

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelly L Marsteller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1205103520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-7575",
            "fax_number": "717-812-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD STE 105",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035049",
            "telephone_number": "717-851-7575",
            "fax_number": "717-812-5154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2339 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035009",
            "country_code": "US",
            "telephone_number": "717-851-6207",
            "fax_number": "717-851-3027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DN004679",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MARSTELLER",
            "middle_name": "L",
            "credential": "RD, LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gurkamal Bobby Dhillon, DO
• Diakon Child, Family & Community Ministries (Diakon Family Life York)
• Joranny Diaz Valdez
• Maria C Diaz, CRNP
• Grey Maria Dickinson, CRNA
• Dana Marie Diehl
• Marjorie Dierdorf
• Carrie Dierdorff
• Donald Richard Dietrich, D.M.D.
• Malcolm Howard Dietrich, D.O.

• Registered Dietitian in York, PA
• Providers in York, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.