Active NPI
Kaitlyn Eigenbrode, RD,LDN
- Registered Dietitian
- Mary Esther, FL
National Provider Identifier
1649803834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND9634
- Practice address
- 530 E Timberlake Dr
Mary Esther, FL 32569-2272 - Phone
- (717) 398-7001
- NPI assigned
- Feb 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND9634 | FL | Primary |
Addresses
Primary practice location
530 E Timberlake Dr
Mary Esther, FL 32569-2272
Mailing address
530 E Timberlake Dr
Mary Esther, FL 32569-2272
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND9634 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1649803834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 E TIMBERLAKE DR",
"city": "MARY ESTHER",
"state": "FL",
"postal_code": "325692272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E TIMBERLAKE DR",
"city": "MARY ESTHER",
"state": "FL",
"postal_code": "325692272",
"telephone_number": "717-398-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIGENBRODE",
"first_name": "KAITLYN",
"credential": "RD,LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-17",
"last_updated": "2020-02-17",
"certification_date": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND9634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mary Esther, FL
- Dr. McGuire, NP LLC (New Hope Mental Health and Wellness)
- Ashley Rayan Driver-Bryant
- Viveca L Durant-Amos
- Kristian David Edlund, O.D.
- Shanaire Moya Edwards
- Rana Elkassih, PA-C
- Emerald Coast Counseling & Associates
- Emerald Coast Psychiatric Care PA
- Michelle Espinoza, LMHC
- Leonard William Fabian III, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.