Active NPI
McKenzie Taylor Derennaux, RD, LD
- Registered Dietitian
- Saint Louis, MO
National Provider Identifier
1447090857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2024013834
- Practice address
- 10010 Kennerly Rd
Saint Louis, MO 63128-2106 - Phone
- (314) 525-1986
- NPI assigned
- May 31, 2024
- 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 | 2024013834 | MO | Primary |
Addresses
Primary practice location
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Mailing address
6343 Fyler Ave
Saint Louis, MO 63139-2026
Phone (314) 623-9094
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2024013834 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthier Tomorrows, PLLC | 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": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1447090857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6343 FYLER AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631392026",
"telephone_number": "314-623-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10010 KENNERLY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282106",
"telephone_number": "314-525-1986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERENNAUX",
"first_name": "MCKENZIE",
"middle_name": "TAYLOR",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2024013834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.