Individual provider Active NPI

Kelly Marie Maples, DTR

  • Registered Dietetic Technician
  • Downey, CA
National Provider Identifier
1487217469
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Dietetic TechnicianTaxonomy code 136A00000X
License
00871931 Issued in CA
Practice address
7601 E. Imperial Hwy
Downey, CA 90242
Phone
(562) 385-7747
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietetic Technician 136A00000X 00871931 CA Primary

Addresses

Primary practice location

7601 E. Imperial Hwy
Downey, CA 90242

Mailing address

7601 E. Imperial Hwy
Downey, CA 90242
Phone (562) 385-7747

Other practice location 1

7601 E. Imperial Hwy
Downey, CA 90242
Phone (562) 385-7747

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

LicenseStateTypeSpecialty
00871931CAMDRegistered Dietetic Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1487217469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 E. IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-385-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 E. IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-385-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7601 E. Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "90242",
            "country_code": "US",
            "telephone_number": "562-385-7747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAPLES",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "DTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "CA",
            "license": "00871931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.