Kristen Ernst Petterson, RD

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

631196

Practice address

226 Walnut St
Montclair, NJ 07042-2972

Phone

(973) 224-7644

Fax

(973) 695-2003

NPI assigned

Sep 4, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1295983146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43463",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070430463",
            "telephone_number": "973-224-7644",
            "fax_number": "973-695-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 WALNUT ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422972",
            "telephone_number": "973-224-7644",
            "fax_number": "973-695-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "KRISTEN",
        "middle_name": "ERNST",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "631196",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": "631196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Perez, LAC
• Rachel H Perlman, LCSW
• Aniella Lincoln Perold, PHD
• Brianna Peterson
• Edward Petrarca, LCSW
• Andrea Peyser, LCSW
• Bruce Phariss, MD
• Physical Medicine and Rehabilitation Associates LLC
• Kevin Picardo, DPT
• Christina Pierre-Noel, MSW, LCSW

• Renal Nutrition Registered Dietitian in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Renal Nutrition Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.