Kimberly Kern, RD, LD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2010033110 Issued in MO

Practice address

1012 N Main St
Sikeston, MO 63801-5044

Phone

(573) 471-0330

NPI assigned

Feb 8, 2012

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1699047464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2010033110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.