Individual provider Active NPI

Teresia F. Huddleston, MSRD, LD

  • Registered Dietitian
  • Bowling Green, KY
National Provider Identifier
1649553041
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2625 Scottsville Rd
Bowling Green, KY 42104-4477
Phone
(270) 745-0942
Fax
(270) 745-0683
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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 Primary

Addresses

Primary practice location

2625 Scottsville Rd
Bowling Green, KY 42104-4477

Mailing address

PO Box 90010
Bowling Green, KY 42102-9010
Phone (270) 745-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000204 KY Practitioner - Registered Dietitian Or Nutrition Professional 3779578885 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Commonwealth Health Corporation, Inc CurrentSince Nov 1, 2016 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 106
Bowling Green, KY 42101
Phone (270) 721-7265

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

825 2nd Ave
Ste A4
Bowling Green, KY 42101
Phone (270) 796-6333

825 2nd Ave
Ste C3
Bowling Green, KY 42101
Phone (270) 780-2660

Organizations & group practices 4

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": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1649553041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90010",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421029010",
            "telephone_number": "270-745-1100",
            "fax_number": "270-745-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SCOTTSVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044477",
            "telephone_number": "270-745-0942",
            "fax_number": "270-745-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "TERESIA",
        "middle_name": "F.",
        "credential": "MSRD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.