Active NPI
Kelly Barnes
- Registered Dietitian
- Rancho Cordova, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 931140
- Practice address
- 11705 Loisdale Way
Rancho Cordova, CA 95742-8028 - Phone
- (916) 208-0552
- NPI assigned
- May 12, 2020
- Last updated
- May 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 931140 | CA | Primary |
Addresses
Primary practice location
11705 Loisdale Way
Rancho Cordova, CA 95742-8028
Mailing address
11705 Loisdale Way
Rancho Cordova, CA 95742-8028
Phone (916) 208-0552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 931140 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Current | Accepting new patients |
Locations
4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872
515 S Flower St
#1015
Los Angeles, CA 90071
500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000
10260 SW Greenburg Rd
#4
Portland, OR 97223
Phone (513) 845-1656
3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589241600000",
"number": "1578185674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11705 LOISDALE WAY",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957428028",
"telephone_number": "916-208-0552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11705 LOISDALE WAY",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957428028",
"telephone_number": "916-208-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNES",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-12",
"last_updated": "2020-05-12",
"certification_date": "2020-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "931140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.