Active NPI
Kulsum Raja, REGISTERED DIETITIAN
- Registered Dietitian
- Denton, TX
National Provider Identifier
1407589104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT82280
- Practice address
- 2800 Shoreline Dr Ste 120
Denton, TX 76210-0130 - Phone
- (940) 383-1240
- NPI assigned
- Jul 8, 2022
- 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 | DT82280 | TX | Primary |
Addresses
Primary practice location
2800 Shoreline Dr Ste 120
Denton, TX 76210-0130
Mailing address
17322 Meadow Light Dr
Richmond, TX 77407-2648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133V00000X | Medicaid | TX |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1407589104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17322 MEADOW LIGHT DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774072648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 SHORELINE DR STE 120",
"city": "DENTON",
"state": "TX",
"postal_code": "762100130",
"telephone_number": "940-383-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJA",
"first_name": "KULSUM",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-08",
"last_updated": "2022-07-08",
"certification_date": "2022-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT82280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133V00000X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.