Individual provider Active NPI

Kristin Longfellow, R.D.

  • Registered Dietitian
  • Flowood, MS
National Provider Identifier
1508208562
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D1467 Issued in MS
Practice address
1030 River Oaks Dr
Flowood, MS 39232-9553
Phone
(601) 936-1009
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D1467 MS Primary

Addresses

Primary practice location

1030 River Oaks Dr
Flowood, MS 39232-9553

Mailing address

609 Mockingbird Cir
Brandon, MS 39047-7373
Phone (903) 521-4407

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
D1467MSMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1508208562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 MOCKINGBIRD CIR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477373",
            "telephone_number": "903-521-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329553",
            "telephone_number": "601-936-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGFELLOW",
        "first_name": "KRISTIN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D1467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.