Active NPI
Kyleigh Glass, RDN
- Registered Dietitian
- Marianna, AR
National Provider Identifier
1285458455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT91325
- Practice address
- 42 Lee Road 179
Marianna, AR 72360-7885 - Phone
- (870) 514-8764
- NPI assigned
- Nov 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT91325 | TX | Primary |
Addresses
Primary practice location
42 Lee Road 179
Marianna, AR 72360-7885
Mailing address
42 Lee Road 179
Marianna, AR 72360-7885
Phone (870) 514-8764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT91325 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1285458455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 LEE ROAD 179",
"city": "MARIANNA",
"state": "AR",
"postal_code": "723607885",
"telephone_number": "870-514-8764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 LEE ROAD 179",
"city": "MARIANNA",
"state": "AR",
"postal_code": "723607885",
"telephone_number": "870-514-8764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "KYLEIGH",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-13",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT91325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marianna, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.