Kelly Jean Crusenberry

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

719 Middle Creek Rd
Sevierville, TN 37862-5016

Phone

(865) 453-1032

NPI assigned

May 15, 2018

Last updated

May 15, 2018By 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

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1275023301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625016",
            "telephone_number": "865-453-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625016",
            "telephone_number": "865-453-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSENBERRY",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Registered Dietitian in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.