Individual provider Active NPI

Kimberly Renee Ayres, RD LD

  • Registered Dietitian
  • Durango, CO
National Provider Identifier
1669473161
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
860735 Issued in CO
Practice address
810 E 3Rd St Unit 201
Durango, CO 81301-5759
Phone
(970) 764-1790
Fax
(970) 375-7927
NPI assigned
Aug 9, 2005
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 860735 CO Primary

Addresses

Primary practice location

810 E 3Rd St Unit 201
Durango, CO 81301-5759

Mailing address

PO Box 1328
Durango, CO 81302-1328
Phone (970) 335-2232

Other practice location 1

1970 E 3rd Ave Ste 1
Durango, CO 81301-5049
Phone (970) 335-2288

Other names 1

  • Kimberly Renee Underhill Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200128001429 CO Practitioner - Registered Dietitian Or Nutrition Professional 0941296321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total HealthcareGroup PAC ID 1052214814, 27 clinicians

Practice addresses (Care Compare)

810 E 3Rd St
201 PRMN PC Mercy North
Durango, CO 81301-5759
Phone (970) 764-1790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1036KSMDMental Health Counselor
860735COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Total Healthcare CurrentSince Dec 31, 2019 Accepting new patients
Total Healthcare Current Accepting new patients
Southwest Colorado Mental Health Center, Inc Current Accepting new patients
Total Healthcare Past Accepting new patients
Nutrition in Motion Dietitian, Registered Past Accepting new patients
Southwest Colorado Mental Health Center, Inc PastSince Mar 31, 2020 Accepting new patients
Total Healthcare Past Accepting new patients

Locations

480 Wolverine Dr
Ste 3
Bayfield, CO 81122
Phone (970) 764-9150

691 E Empire St
Cortez, CO 81321
Phone (970) 335-2232

495 W 4th St
Dove Creek, CO 81324
Phone (970) 677-2291

1 Mercado St
Ste 160
Durango, CO 81301
Phone (970) 385-9850

1970 E 3rd Ave
Ste 1
Durango, CO 81301
Phone (970) 335-2288

810 E 3rd St
Unit 201
Durango, CO 81301
Phone (970) 764-1790

Organizations & group practices 7

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1669473161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813021328",
            "telephone_number": "970-335-2232",
            "fax_number": "970-335-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 3RD ST UNIT 201",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015759",
            "telephone_number": "970-764-1790",
            "fax_number": "970-375-7927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 E 3rd Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813015049",
            "country_code": "US",
            "telephone_number": "970-335-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYRES",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "credential": "RD LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "860735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "UNDERHILL",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.