Organization Active NPI

Nutrition With Kyra Tywanick RDN

  • Registered Dietitian
  • Clinton, NJ
National Provider Identifier
1649017542
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
NUTRITION WITH KYRA TYWANICK RDN
Practice address
21 Fieldstone Dr
Clinton, NJ 08809-1390
Phone
(908) 894-4561
NPI assigned
Jul 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Kyra Tywanick, RDNNPI 1871341263
Title
Registered Dietitian
Phone
(908) 894-4561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

21 Fieldstone Dr
Clinton, NJ 08809-1390

Mailing address

21 Fieldstone Dr
Clinton, NJ 08809-1390
Phone (908) 894-4561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611004198 NJ Part B Supplier - Clinic/Group Practice 7517477102 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1649017542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 FIELDSTONE DR",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091390",
            "telephone_number": "908-894-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FIELDSTONE DR",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091390",
            "telephone_number": "908-894-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION WITH KYRA TYWANICK RDN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "TYWANICK",
        "authorized_official_first_name": "KYRA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "908-894-4561",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.