Active NPI
Kacey Elizabeth Conyers, MS, RD, LD
- Registered Dietitian
- Warm Springs, OR
National Provider Identifier
1356758189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D-10163387
- Practice address
- 1270 Kotnum Rd
Warm Springs, OR 97761 - Phone
- (541) 553-1196
- Fax
- (541) 553-2457
- NPI assigned
- Jul 14, 2014
- 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 | LD-D-10163387 | OR | Primary |
Addresses
Primary practice location
1270 Kotnum Rd
Warm Springs, OR 97761
Mailing address
1270 Kotnum Rd
Warm Springs, OR 97761
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD-D-10163387 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1356758189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1270 KOTNUM RD",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "97761",
"fax_number": "541-553-2457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1270 KOTNUM RD",
"city": "WARM SPRINGS",
"state": "OR",
"postal_code": "97761",
"telephone_number": "541-553-1196",
"fax_number": "541-553-2457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONYERS",
"first_name": "KACEY",
"middle_name": "ELIZABETH",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-10163387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warm Springs, OR
- Confederated Tribes of the Warm Springs Reservation of Oregon
- Confederated Tribes of the Warm Springs Reservation of Oregon
- Confederated Tribes of the Warm Springs Reservation of Oregon
- Confederated Tribes of the Warm Springs Reservation of Oregon
- Confederated Tribes of Warm Springs Reservation of Oregon
- Rust Dee Corey, OD
- Sandra Lynn Cota, RDH
- Thomas James Creelman, M.D.
- Jeannette Delosangeles, PHARMD
- Denise Marie Devore, RN BSN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.