Kelly Goodson, MPH, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND7621 Issued in FL

Practice address

97 W Oak Ave
Panama City, FL 32401-2735

Phone

(850) 273-5867

NPI assigned

Oct 4, 2017

Last updated

Feb 25, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1407366446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 GALLBERRY AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 W OAK AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012735",
            "telephone_number": "850-273-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "MPH, RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-02-25",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GN Hearing Care Corp. Dba/ Beltone Electronics
• Christopher Godwin, CRNA
• Antoinette Marie Golden
• Jeanne Goldie, OTR/L
• Geraldine Delong Goldman, LSCW, PHD
• Steven Everett Goodwiller, MD PA
• Kevin L Goodwin
• Kathryn Leigh Gordon-Dick, MS CCC-SLP
• Leslie J. Gorman-Anich, LMHC
• Gary D Gorman, M.D.

• Registered Dietitian in Panama City, FL
• Providers in Panama City, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.