Kristen Bevilacqua, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

9415 E Harry St Ste 407
Wichita, KS 67207-5083

Phone

(316) 252-1154

NPI assigned

Nov 27, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Healthy Green Nutrition, LLC

  • Registered Dietitian
  • Wichita, KS
  • NPI 1568839868

  Dietitian, Registered

  NPD

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1669248191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9714 W MAXWELL ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672151550",
            "telephone_number": "316-644-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 E HARRY ST STE 407",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672075083",
            "telephone_number": "316-252-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "KRISTEN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKensie Bevens, DO, ATC
• Kylee Beverage
• Jacqueline Beverlin
• Owen Beverlin, DO
• Alessandra Jeanine Bevilacqua
• Denae Marguerite Beville, D.O.
• Janie Bey
• Jason Beyer
• Joshua Beyer
• Linda L. Beyer, CPTA

• All providers in Wichita, KS
• Registered Dietitian in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.