Individual provider Active NPI

Anna Noble Brister, MS, RD, LD, CLC

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1598504722
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86119797 Issued in MS
Practice address
3724 Jefferson St Ste 104
Austin, TX 78731-6204
Phone
(601) 754-2670
NPI assigned
May 20, 2024
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D2084 MS
Registered Dietitian 133V00000X DT90395 TX
Registered Dietitian 133V00000X 86119797 MS Primary

Addresses

Primary practice location

3724 Jefferson St Ste 104
Austin, TX 78731-6204

Mailing address

1011 Preston Dr
Brandon, MS 39047-8169
Phone (601) 754-2670

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86119797MSMDRegistered Dietitian
D2084MSMDRegistered Dietitian
DT90395TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Maternal Wellness, LLC Dietitian, Registered CurrentSince May 26, 2024 Accepting new patients

Locations

270 Trace Colony Park Dr
#B
Ridgeland, MS 39157
Phone (601) 215-5545

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1598504722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PRESTON DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390478169",
            "telephone_number": "601-754-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316204",
            "telephone_number": "601-754-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTER",
        "first_name": "ANNA",
        "middle_name": "NOBLE",
        "credential": "MS, RD, LD, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D2084",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT90395",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "86119797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.