NPIMap

Organization Active NPI

Your Specialized Dietitian

  • Registered Dietitian
  • Whitesboro, TX
National Provider Identifier
1285029017
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT80568 Issued in TX
Legal business name
YOUR SPECIALIZED DIETITIAN
Practice address
408 W Main St
Whitesboro, TX 76273-1641
Phone
(903) 816-3657
Fax
(817) 977-7406
NPI assigned
Mar 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Kyle Fielding Rose, RDNPI 1467624858
Title
Owner
Phone
(903) 816-3657

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X DT80568 TX Primary

Addresses

Primary practice location

408 W Main St
Whitesboro, TX 76273-1641

Mailing address

408 West Main St
Whitesboro, TX 76273
Phone (903) 816-3657

National Provider Directory

National Provider Directory

Locations

231 W Main St
Ste 107
Denison, TX 75020
Phone (903) 816-3657

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1285029017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WEST MAIN ST",
            "city": "WHITESBORO",
            "state": "TX",
            "postal_code": "76273",
            "telephone_number": "903-816-3657",
            "fax_number": "817-977-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W MAIN ST",
            "city": "WHITESBORO",
            "state": "TX",
            "postal_code": "762731641",
            "telephone_number": "903-816-3657",
            "fax_number": "817-977-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SPECIALIZED DIETITIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "FIELDING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-816-3657",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.