Kathryn Drea-Cullen Doermann, MS, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L005235 Issued in NC

Practice address

1210 New Garden Rd
Greensboro, NC 27410-2721

Phone

(336) 294-6190

Fax

(336) 294-6278

NPI assigned

Sep 2, 2022

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Eagle Physicians and Associates PA

  dba Eagle Family Medicine @ Guilford College

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982
  Medicare reassignment Care Compare group NPD
• Eagle Physicians and Associates PA

  dba Eagle Physical Therapy

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD
• Eagle Physicians and Associates PA

  dba Eagle Gastroenterology

  • Gastroenterology Physician
  • Greensboro, NC
  • NPI 1073698502
  NPD (past)
• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648
  NPD (past)

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1649990102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 MADISON AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031033",
            "telephone_number": "980-297-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190",
            "fax_number": "336-294-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERMANN",
        "first_name": "KATHRYN",
        "middle_name": "DREA-CULLEN",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L005235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kathryn.Doermann@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Henry Dixon III, LMBT
• Alfonso Diy
• Laura Doan, CFY-SLP
• Channel Dion Dobson, MSN, FNP, RN
• Andrew J Dodson, PHARMD
• Lauren K Dogariu, PAC
• Carmen Dohmeier, M.D.
• Tiffany W Dohner, M.A., CCC-SLP
• Whitney Ann Doiron, NP
• Stesha Adai Doku, MD

• Registered Dietitian in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.