Andrea Kay Brettin, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.006956 Issued in IL

Practice address

501 Lake Land Blvd
Mattoon, IL 61938-5283

Phone

(217) 554-3000

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Kay Hussong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306349469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAKE LAND BLVD",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619385283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 LAKE LAND BLVD",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619385283",
            "telephone_number": "217-554-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5850 6th Street Frontage Rd E Ste A",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627035194",
            "country_code": "US",
            "telephone_number": "217-554-3000 x47409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRETTIN",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HUSSONG",
            "middle_name": "KAY",
            "credential": "RDN, LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Bosley
• Steve Boyars, B.A.
• Sara Boysen
• Marlana Lynne Brant, RDH
• Mark Bratton, BA
• Chelsea Brettin
• Alex C Brewer
• Eric M Brewer, D.O.
• Stephanie Brewer, BS, MHP
• Brookstone Estates of Mattoon North

• Registered Dietitian in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.