Individual provider Active NPI

Kelly Drew, R.D., C.D.

  • Registered Dietitian
  • West Allis, WI
National Provider Identifier
1588009443
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2342-029 Issued in WI
Practice address
736 S 105TH St
West Allis, WI 53214-2542
Phone
(262) 853-0509
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 2342-029 WI Primary

Addresses

Primary practice location

736 S 105TH St
West Allis, WI 53214-2542

Mailing address

736 S 105TH St
West Allis, WI 53214-2542

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
2342-029WIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1588009443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 S 105TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 S 105TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142542",
            "telephone_number": "262-853-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "KELLY",
        "credential": "R.D., C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2342-029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.