Active NPI
Beverly Kay Kastan, R.D., M.S., MLDE.
- Registered Dietitian
- Louisville, KY
National Provider Identifier
1275685828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 169351
- Practice address
- 5802 Brittany Valley Rd
Louisville, KY 40222-5904 - Phone
- (502) 891-0360
- Fax
- (502) 891-0360
- NPI assigned
- Jan 16, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | KY0025 | KY | |
| Registered Dietitian | 133V00000X | 169351 | KY | Primary |
Addresses
Primary practice location
5802 Brittany Valley Rd
Louisville, KY 40222-5904
Mailing address
5802 Brittany Valley Rd
Louisville, KY 40222-5904
Phone (502) 891-0360
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10654330662 | Other | KY | HUMANA |
| 176894 | Other | KY | ANTHEM BLUE CROSS BLUE SH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2015 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 169351 | KY | MD | Registered Dietitian |
| KY0025 | KY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1275685828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5802 BRITTANY VALLEY RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402225904",
"telephone_number": "502-891-0360",
"fax_number": "502-891-0360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5802 BRITTANY VALLEY RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402225904",
"telephone_number": "502-891-0360",
"fax_number": "502-891-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASTAN",
"first_name": "BEVERLY",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "R.D., M.S., MLDE.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "KY0025",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "169351",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "10654330662",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "176894",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.