Individual provider Active NPI

Kimberly Edwards

  • Registered Dietitian
  • Beaufort, SC
National Provider Identifier
1285001834
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
712 Issued in SC
Practice address
990 Ribaut Rd
Beaufort, SC 29902-8011
Phone
(843) 522-5562
NPI assigned
Aug 31, 2015
Last updated
Aug 31, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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 712 SC Primary

Addresses

Primary practice location

990 Ribaut Rd
Beaufort, SC 29902-8011

Mailing address

990 Ribaut Rd
Beaufort, SC 29902-8011
Phone (843) 522-5562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190513000252 SC Practitioner - Registered Dietitian Or Nutrition Professional 9739422817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Mar 2, 2019 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Mar 2, 2019 Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients

Locations

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

955 Ribaut Rd
#C
Beaufort, SC 29902

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

990 Ribaut Rd
Beaufort, SC 29902
Phone (843) 522-5565

Organizations & group practices 3

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": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1285001834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299028011",
            "telephone_number": "843-522-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299028011",
            "telephone_number": "843-522-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.