Kimberly Nicole Tadlock, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

961860 Issued in MS

Practice address

532 Peebles Ave
Philadelphia, MS 39350-2238

Phone

(601) 927-7272

NPI assigned

May 1, 2025

Last updated

May 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicki Stone Other name

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": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1629867171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 PEEBLES AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 PEEBLES AVE",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502238",
            "telephone_number": "601-927-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADLOCK",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "961860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICKI",
            "last_name": "STONE",
            "credential": "RDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Whitney Lauren Stokes, OTR/L
• Stribling Drug Store
• Richard Kent Stribling, O.D.
• Trent A Stribling, O.D.
• Surgery Clinic of Philadelphia
• Katie Taylor, CMHC
• Shelby Smith Thames
• The Medical Store, Inc. (The Medical Store, Inc./Philadelphia)
• Denita Kaye Thomas, FNP
• Julie Thomas

• Registered Dietitian in Philadelphia, MS
• Providers in Philadelphia, MS by specialty
• Registered Dietitian in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.