NPIMap

Organization Active NPI

KJM Dietetics LLC

  • Registered Dietitian
  • Morrisville, NC
National Provider Identifier
1679187827
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
KJM DIETETICS LLC
Practice address
102 Stardale Rd
Morrisville, NC 27560-7064
Phone
(718) 581-8659
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Kylee-Jean Wormuth, RD
Title
Owner
Phone
(718) 581-8659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

102 Stardale Rd
Morrisville, NC 27560-7064

Mailing address

102 Stardale Rd
Morrisville, NC 27560-7064
Phone (718) 581-8659

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1679187827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 STARDALE RD",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275607064",
            "telephone_number": "718-581-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 STARDALE RD",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275607064",
            "telephone_number": "718-581-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJM DIETETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "WORMUTH",
        "authorized_official_first_name": "KYLEE-JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-581-8659",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.