Individual provider Active NPI

Kelly Jon Brower, R.D.

  • Registered Dietitian
  • Chapel Hill, NC
National Provider Identifier
1689941502
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L003424 Issued in NC
Practice address
101 Manning Dr
Department Outpatient Medical Nutrition
Chapel Hill, NC 27514-4220
Phone
(919) 966-0837
Fax
(984) 974-1191
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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 L003424 NC Primary

Addresses

Primary practice location

101 Manning Dr
Department Outpatient Medical Nutrition
Chapel Hill, NC 27514-4220

Mailing address

101 Manning Dr
Department Outpatient Medical Nutrition
Chapel Hill, NC 27514-4220
Phone (919) 966-0837

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150123002230 NC Practitioner - Registered Dietitian Or Nutrition Professional 3678897543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L003424NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Nov 11, 2014 Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Nov 11, 2014 Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1689941502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "address_2": "DEPARTMENT OUTPATIENT MEDICAL NUTRITION",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "919-966-0837",
            "fax_number": "984-974-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "address_2": "DEPARTMENT OUTPATIENT MEDICAL NUTRITION",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "919-966-0837",
            "fax_number": "984-974-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "KELLY",
        "middle_name": "JON",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L003424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.