Active NPI
Kayleigh King, RD
- Registered Dietitian
- Cabot, AR
National Provider Identifier
1356828651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1621
- Practice address
- 100 Gateway Dr
Cabot, AR 72023-8606 - Phone
- (501) 295-7105
- Fax
- (501) 229-6070
- NPI assigned
- Jul 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 1621 | AR | Primary |
Addresses
Primary practice location
100 Gateway Dr
Cabot, AR 72023-8606
Mailing address
339 Austin Creek Dr
Austin, AR 72007-9740
Phone (501) 295-7105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190508002894 | AR | Practitioner - Registered Dietitian Or Nutrition Professional | 0648512806 | Practice locations: Little Rock, AR |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4 Shackleford PLZ
Suite 212
Little Rock, AR 72211-1844
Phone (501) 295-7105
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1356828651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 AUSTIN CREEK DR",
"city": "AUSTIN",
"state": "AR",
"postal_code": "720079740",
"telephone_number": "501-295-7105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GATEWAY DR",
"city": "CABOT",
"state": "AR",
"postal_code": "720238606",
"telephone_number": "501-295-7105",
"fax_number": "501-229-6070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KAYLEIGH",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-19",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "1621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.