Organization Active NPI

Dietitian Kaitlyn LLC

  • Registered Dietitian
  • Leland, NC
National Provider Identifier
1215689898
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
DIETITIAN KAITLYN LLC
Practice address
2155 Britton Rd Unit 110
Leland, NC 28451-1929
Phone
(910) 408-5338
NPI assigned
Jan 25, 2022
Last updated
Jan 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Kaitlyn Seguin, RDNPI 1134871718
Title
Dietitian
Phone
(910) 408-5338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

2155 Britton Rd Unit 110
Leland, NC 28451-1929

Mailing address

2155 Britton Rd Unit 110
Leland, NC 28451-1929
Phone (910) 408-5338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220706002873 NC Part B Supplier - Clinic/Group Practice 1254711492 Receives reassigned benefits from 1 practitioner
Practice locations: Leland, NC

National Provider Directory

National Provider Directory

Locations

2155 Britton Rd
Ste 110
Leland, NC 28451
Phone (910) 408-1747

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1215689898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 BRITTON RD UNIT 110",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511929",
            "telephone_number": "910-408-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 BRITTON RD UNIT 110",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284511929",
            "telephone_number": "910-408-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETITIAN KAITLYN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "SEGUIN",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "910-408-5338",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.