Allison Mary Kallberg, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2040 Issued in CT

Practice address

22 Masonic Ave
Wallingford, CT 06492-3048

Phone

(203) 679-5900

NPI assigned

Oct 5, 2024

Last updated

Oct 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1255150405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 BOULEVARD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191912",
            "telephone_number": "203-837-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-679-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Boulevard",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061191912",
            "country_code": "US",
            "telephone_number": "203-837-6817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLBERG",
        "first_name": "ALLISON",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "2040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Registered Dietitian in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; 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.