Individual provider Active NPI

Anne Kristine Moore Etherton, RD

  • Registered Dietitian
  • Chesapeake, VA
National Provider Identifier
1275001430
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218
Phone
(757) 339-3624
NPI assigned
Nov 6, 2018
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 NU Primary

Addresses

Primary practice location

1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218

Mailing address

1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190222001909 VA Practitioner - Registered Dietitian Or Nutrition Professional 9335488105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuleeu Nutrition and Wellness, LLCGroup PAC ID 7517206386, 2 clinicians

Practice addresses (Care Compare)

501 Independence Pkwy
Suite 310
Chesapeake, VA 23320-5159
Phone (757) 339-3624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nuleeu Nutrition and Wellness, LLC Dietitian, Registered CurrentSince Feb 1, 2019 Accepting new patients

Locations

1517 Technology Dr
Ste 101
Chesapeake, VA 23320
Phone (757) 339-3624

1545 Crossways Blvd
Ste 250
Chesapeake, VA 23320
Phone (757) 206-2772

501 Independence Pkwy
Ste 310
Chesapeake, VA 23320

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": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1275001430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD STE 250",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD STE 250",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200218",
            "telephone_number": "757-339-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERTON",
        "first_name": "ANNE KRISTINE",
        "middle_name": "MOORE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.