Individual provider Active NPI

Kerri Taylor, RD

  • Registered Dietitian
  • North Myrtle Beach, SC
National Provider Identifier
1508505124
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2443 Issued in SC
Practice address
1016 2ND Ave N Ste 206G
North Myrtle Beach, SC 29582-8209
Phone
(910) 239-3562
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 2443 SC Primary

Addresses

Primary practice location

1016 2ND Ave N Ste 206G
North Myrtle Beach, SC 29582-8209

Mailing address

1133 Medical Center Dr
Wilmington, NC 28401-7304
Phone (910) 239-3562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627000679 SC Practitioner - Registered Dietitian Or Nutrition Professional 1355720095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nutrition in Motion 16 clinicians

Practice addresses (Care Compare)

1016 2ND Ave N
Suite 206G
North Myrtle Beach, SC 29582-8209
Phone (910) 239-3562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2443SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition in Motion Dietitian, Registered CurrentSince Jun 18, 2022 Accepting new patients
Norma J Cortez DDS PA PastSince Jun 5, 2022 Accepting new patients

Locations

1133 Medical Center Dr
Wilmington, NC 28401
Phone (910) 763-0931

1016 2nd Ave N
Ste 206G
North Myrtle Beach, SC 29582

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1508505124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017304",
            "telephone_number": "910-239-3562",
            "fax_number": "877-889-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 2ND AVE N STE 206G",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295828209",
            "telephone_number": "910-239-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KERRI",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "2443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.