Casey Kerbs, RDN, CDN
Individual provider Active NPI Registered Dietitian · Southold, NY
NPI 1467017293 · NPPES record last updated May 7, 2019
Key facts
- NPI
- 1467017293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 009080 (NY)
- Practice address
- 1455 Old Shipyard LN
Southold, NY 11971-1539 - Phone
- (631) 275-2370
- NPI assigned
- May 7, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1099557 | NY | MD | Registered Dietitian |
| 009080 | NY | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1099557 | NY | |
| Registered Dietitian | 133V00000X | 009080 | NY | Yes |
Addresses
Primary practice location
1455 Old Shipyard LN
Southold, NY 11971-1539
Mailing address
430 Riley Ave
Mattituck, NY 11952-1804
Phone (631) 275-2370
Other providers in Southold, NY
- Jelaine Physical Therapy, PLLC
- Peter Kevin Johnstone Jr.
- Nicholas Kardaras
- Harriette Keely
- Noreen Bawn Kelly
- Jeanne Kiernan
- Irene Kontoleon
- Anna Kozlowska
- Robert T Kroepel
- Kathryn Krukowski
All providers in Southold, NY · Registered Dietitian in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.