Active NPI
Katheryn Marie Peebles, RD,CDE
- Registered Dietitian
- Chester, VA
National Provider Identifier
1477067189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 46035
- Practice address
- 12201 Percival St
Chester, VA 23831-4430 - Phone
- (804) 310-5720
- Fax
- (804) 287-7839
- NPI assigned
- Nov 17, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 46035 | VA | Primary |
Addresses
Primary practice location
12201 Percival St
Chester, VA 23831-4430
Mailing address
12201 Percival St
Chester, VA 23831-4430
Phone (804) 310-5720
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 |
|---|---|---|---|
| 46035 | VA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510876800000",
"number": "1477067189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 PERCIVAL ST",
"city": "CHESTER",
"state": "VA",
"postal_code": "238314430",
"telephone_number": "804-310-5720",
"fax_number": "804-287-7839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 PERCIVAL ST",
"city": "CHESTER",
"state": "VA",
"postal_code": "238314430",
"telephone_number": "804-310-5720",
"fax_number": "804-287-7839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEEBLES",
"first_name": "KATHERYN",
"middle_name": "MARIE",
"credential": "RD,CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-17",
"last_updated": "2017-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "46035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chester, VA
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- Pediatric Assoc of Petersburg
- People 1St Health and Residential Services, LLC
- People Transport LLC
- Perfect Choice Transportation LLC
- William Connor Perry, DPT
- Phoebe Care Residential Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.