Adyson Mitchell Klingenberg, MS RD LD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

DT85915 Issued in TX

Practice address

1500 Cooper St
Fort Worth, TX 76104-2710

Phone

(682) 885-1990

Fax

(682) 885-1985

NPI assigned

Jul 3, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1336701986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042710",
            "telephone_number": "682-885-1990",
            "fax_number": "682-885-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENBERG",
        "first_name": "ADYSON",
        "middle_name": "MITCHELL",
        "credential": "MS RD LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT85915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Kay Klempel, DPH
• Geoffrey Philip Kline, DO, PHD
• Kathryn Leah Kline, MD
• Tonia M Kline, CCCSLP
• Harry Fitch Klinefelter III, PHD
• Rikki Klingenberg
• Stefanie Klintworth, LCSW
• Dragana Vujic Kljaic, AGACNP
• Klock & Nail Enterprise Inc
• Kristen Michelle Kluber, DO

• Pediatric Nutrition Registered Dietitian in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.