Living Well With KB LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LIVING WELL WITH KB LLC

Practice address

6831 George Washington Mem Hwy
Yorktown, VA 23692-4805

Phone

(757) 869-0236

NPI assigned

Sep 11, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Katelyn Suzanna Brockmiller, RD

Title

Dietitian

Phone

(757) 869-0236

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1659158988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 ALLEN HARRIS DR",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236924882",
            "telephone_number": "757-869-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6831 GEORGE WASHINGTON MEM HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236924805",
            "telephone_number": "757-869-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL WITH KB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "BROCKMILLER",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_middle_name": "SUZANNA",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "757-869-0236",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Health Service Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.