Deidre Thompson, RD, LD, CSR

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

2003005685 Issued in MO

Practice address

11366 Flowers Dr
Dexter, MO 63841-9135

Phone

(573) 624-0995

NPI assigned

Feb 5, 2025

Last updated

Feb 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1578377016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11366 FLOWERS DR",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638419135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11366 FLOWERS DR",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638419135",
            "telephone_number": "573-624-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEIDRE",
        "credential": "RD, LD, CSR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "MO",
            "license": "2003005685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Renal Nutrition Registered Dietitian in Dexter, MO
• Providers in Dexter, MO by specialty
• Renal Nutrition Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.