Active NPI
Kimberly Ambrose, RDN
- Registered Dietitian
- Marietta, OH
National Provider Identifier
1255211348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 6983
- Practice address
- 216 Deerwalk Cir
Marietta, OH 45750-5378 - Phone
- (304) 593-1112
- NPI assigned
- Sep 8, 2025
- Last updated
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 6983 | OH | Primary |
Addresses
Primary practice location
216 Deerwalk Cir
Marietta, OH 45750-5378
Mailing address
216 Deerwalk Cir
Marietta, OH 45750-5378
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 |
|---|---|---|---|
| 6983 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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": "1757289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1255211348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 DEERWALK CIR",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457505378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 DEERWALK CIR",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457505378",
"telephone_number": "304-593-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "KIMBERLY",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-08",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "6983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.