Active NPI
Kimberly Marie Chapman, RDN
- Registered Dietitian
- Petal, MS
National Provider Identifier
1467080580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D0958
- Practice address
- 312 Pine Ridge PT
Petal, MS 39465-4241 - Phone
- (601) 248-1687
- Fax
- (888) 820-5115
- NPI assigned
- Apr 1, 2020
- Last updated
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 807390 | NU | |
| Registered Dietitian | 133V00000X | 3100-29 | WI | |
| Registered Dietitian | 133V00000X | 877 | WV | |
| Registered Dietitian | 133V00000X | DN004869 | PA | |
| Registered Dietitian | 133V00000X | LDN0000001995 | TN | |
| Registered Dietitian | 133V00000X | DII00000537 | DC | |
| Registered Dietitian | 133V00000X | 663 | SC | |
| Registered Dietitian | 133V00000X | 2081 | OK | |
| Registered Dietitian | 133V00000X | D-1067 | ID | |
| Registered Dietitian | 133V00000X | LD-1282 | NM | |
| Registered Dietitian | 133V00000X | 1557 | AL | |
| Registered Dietitian | 133V00000X | 2080 | LA | |
| Registered Dietitian | 133V00000X | 1778 | KS | |
| Registered Dietitian | 133V00000X | 123431 | KY | |
| Registered Dietitian | 133V00000X | D0958 | MS | Primary |
Addresses
Primary practice location
312 Pine Ridge PT
Petal, MS 39465-4241
Mailing address
312 Pine Ridge PT
Petal, MS 39465-4241
Phone (601) 248-1687
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1557 | AL | MD | Psychologist |
| 877 | WV | MD | Clinical Psychologist |
| DII00000537 | DC | MD | Registered Dietitian |
| D-1067 | ID | MD | Registered Dietitian |
| 1778 | KS | MD | Registered Dietitian |
| 123431 | KY | MD | Registered Dietitian |
| 2080 | LA | MD | Registered Dietitian |
| D0958 | MS | MD | Registered Dietitian |
| LD-1282 | NM | MD | Registered Dietitian |
| DN004869 | PA | MD | Registered Dietitian |
| LDN0000001995 | TN | MD | Registered Dietitian |
| 3100-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1467080580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 PINE RIDGE PT",
"city": "PETAL",
"state": "MS",
"postal_code": "394654241",
"telephone_number": "601-248-1687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 PINE RIDGE PT",
"city": "PETAL",
"state": "MS",
"postal_code": "394654241",
"telephone_number": "601-248-1687",
"fax_number": "888-820-5115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAPMAN",
"first_name": "KIMBERLY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": "807390",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "3100-29",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WV",
"license": "877",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004869",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "LDN0000001995",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DC",
"license": "DII00000537",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "663",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "2081",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D-1067",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "LD-1282",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "1557",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "2080",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KS",
"license": "1778",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "123431",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MS",
"license": "D0958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petal, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.