Individual provider Active NPI

Karen Sue Poenisch, R.D., L.D., C.D.E.

  • Metabolic Nutrition Registered Dietitian
  • San Antonio, TX
National Provider Identifier
1386876381
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
583390 Issued in IN
Practice address
8042 Wurzbach Rd Ste 230
San Antonio, TX 78229-3806
Phone
(210) 963-6100
Fax
(210) 461-5060
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X DT81223 TX
Metabolic Nutrition Registered Dietitian 133VN1006X 583390 IN Primary

Addresses

Primary practice location

8042 Wurzbach Rd Ste 230
San Antonio, TX 78229-3806

Mailing address

12911 Walking Horse
Helotes, TX 78023-4570
Phone (210) 896-0133

Other practice location 1

12911 Walking Horse
Helotes, TX 78023-4570
Phone (210) 896-0133

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT81223TXMDPediatric Nutrition Registered Dietitian
583390INMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sonika Gupta, M.D., PLLC CurrentSince Jul 10, 2022 Accepting new patients

Locations

8042 Wurzbach Rd
Ste 230
San Antonio, TX 78229
Phone (210) 570-5015

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1386876381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 WALKING HORSE",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234570",
            "telephone_number": "210-896-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8042 WURZBACH RD STE 230",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293806",
            "telephone_number": "210-963-6100",
            "fax_number": "210-461-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12911 Walking Horse",
            "address_purpose": "LOCATION",
            "city": "Helotes",
            "state": "TX",
            "postal_code": "780234570",
            "country_code": "US",
            "telephone_number": "210-896-0133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POENISCH",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "credential": "R.D., L.D., C.D.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "TX",
            "license": "DT81223",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IN",
            "license": "583390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.