Active NPI
Kelly Simon, RD
- Registered Dietitian
- Houma, LA
National Provider Identifier
1225534001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2868
- Practice address
- 6433 W Park Ave
Houma, LA 70364-2238 - Phone
- (985) 851-0188
- NPI assigned
- Apr 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2868 | LA | Primary |
Addresses
Primary practice location
6433 W Park Ave
Houma, LA 70364-2238
Mailing address
3379 Brookwood Dr
Houma, LA 70360
Other practice location 1
3379 brookwood dr
houma, LA 70360
Phone (336) 580-0005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2868 | LA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522627200000",
"number": "1225534001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3379 BROOKWOOD DR",
"city": "HOUMA",
"state": "LA",
"postal_code": "70360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6433 W PARK AVE",
"city": "HOUMA",
"state": "LA",
"postal_code": "703642238",
"telephone_number": "985-851-0188"
}
],
"practiceLocations": [
{
"address_1": "3379 brookwood dr",
"address_purpose": "LOCATION",
"city": "houma",
"state": "LA",
"postal_code": "70360",
"country_code": "US",
"telephone_number": "336-580-0005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMON",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-02",
"last_updated": "2018-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "2868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houma, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.