Active NPI
Kelley M Raetzsch, RD, CSSD
- Registered Dietitian
- Fredericksburg, VA
National Provider Identifier
1679699524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3330 Bourbon St
Suite 128
Fredericksburg, VA 22408-7333 - Phone
- (540) 847-7706
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
3330 Bourbon St
Suite 128
Fredericksburg, VA 22408-7333
Mailing address
3330 Bourbon St
Suite 128
Fredericksburg, VA 22408-7333
Phone (540) 847-7706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1679699524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3330 BOURBON ST",
"address_2": "SUITE 128",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224087333",
"telephone_number": "540-847-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 BOURBON ST",
"address_2": "SUITE 128",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224087333",
"telephone_number": "540-847-7706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAETZSCH",
"first_name": "KELLEY",
"middle_name": "M",
"credential": "RD, CSSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.