Individual provider Active NPI

Kayla Perry, RDN, LD

  • Registered Dietitian
  • Marietta, GA
National Provider Identifier
1245894179
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86009311 Issued in GA
Practice address
330 Kennestone Hospital Blvd
Marietta, GA 30060-1121
Phone
(770) 793-7300
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86009311 GA Primary

Addresses

Primary practice location

330 Kennestone Hospital Blvd
Marietta, GA 30060-1121

Mailing address

111 N Marietta Pkwy NE Apt B206
Marietta, GA 30060-1484
Phone (678) 314-0852

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404000543 TX Practitioner - Registered Dietitian Or Nutrition Professional 3678911054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Life Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86009311GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Mar 18, 2024 Accepting new patients

Locations

515 S Flower St
#1015
Los Angeles, CA 90071

250 Fillmore St
Unit 150
Denver, CO 80206
Phone (410) 505-0521

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

10260 SW Greenburg Rd
#4
Portland, OR 97223
Phone (513) 845-1656

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1245894179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MARIETTA PKWY NE APT B206",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601484",
            "telephone_number": "678-314-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 KENNESTONE HOSPITAL BLVD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601121",
            "telephone_number": "770-793-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KAYLA",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "86009311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.