Kimberly A Beavers, MS, RDN, LD, CDE
Individual provider Active NPI Registered Dietitian · Augusta, GA
NPI 1295274199 · NPPES record last updated Feb 14, 2017
Key facts
- NPI
- 1295274199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- LD001544 (GA)
- Practice address
- 3154 Perimeter Pkwy
Suite 2
Augusta, GA 30909-4804 - Phone
- (706) 922-8283
- Fax
- (706) 854-0317
- NPI assigned
- Feb 13, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD001544 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Au Medical Associates Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1299 | SC | |
| Registered Dietitian | 133V00000X | LD001544 | GA | Yes |
Addresses
Primary practice location
3154 Perimeter Pkwy
Suite 2
Augusta, GA 30909-4804
Mailing address
918 River Oak Dr
North Augusta, SC 29841-3282
Phone (706) 922-8283
Other providers in Augusta, GA
- Heather Elise Beattie
- John Crosland Beaty
- Jennifer Beaudreau
- Ronald Beaudreau
- Kristen Boynton Beaufort
- Debra Beazley
- Anna Mae Beck
- Dan Felder Beckman II
- Elizabeth C Becton
- James Louis Becton Jr.
All providers in Augusta, GA · Registered Dietitian in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.