Active NPI
Stacie L Weddington, R.D., L.D.
- Registered Dietitian
- Kimper, KY
National Provider Identifier
1609060243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1372
- Practice address
- 4542 Upper Johns Creek
Kimper, KY 41539 - Phone
- (606) 835-4708
- NPI assigned
- Aug 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1372 | KY | MD | Clinical Social Worker |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1372 | KY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
4542 Upper Johns Creek
Kimper, KY 41539
Mailing address
4542 Upper Johns Creek
Kimper, KY 41539
Phone (606) 835-4708
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 28, 2007.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1609060243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4542 UPPER JOHNS CREEK",
"city": "KIMPER",
"state": "KY",
"postal_code": "41539",
"telephone_number": "606-835-4708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4542 UPPER JOHNS CREEK",
"city": "KIMPER",
"state": "KY",
"postal_code": "41539",
"telephone_number": "606-835-4708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDDINGTON",
"first_name": "STACIE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-28",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "1372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kimper, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.