Kimberly Lyles Cormier, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2220 Issued in LA

Practice address

4630 Ambassador Caffery Pkwy Ste 408
Lafayette, LA 70508-6950

Phone

(337) 470-3980

Fax

(337) 470-3989

NPI assigned

Jan 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1285132043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0002",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY STE 408",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086950",
            "telephone_number": "337-470-3980",
            "fax_number": "337-470-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "KIMBERLY",
        "middle_name": "LYLES",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "2220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2220",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4630 Ambassador Caffery Pkwy Ste 408",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcormier74022@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kcormier74022@direct.casso.us.com",
            "address_1": "4630 Ambassador Caffery Pkwy Ste 408",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy Lynn Cormier
• Douglas Paul Cormier, PHARMD
• Everette J Cormier, LMT
• Jason Cormier, MD
• Joy Cormier
• Lani Huval Cormier, DDS
• Paula Elizabeth Cormier
• Ronald Keith Cormier, D.C.
• Samantha Cormier
• Tammy Cormier

• Registered Dietitian in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.