Individual provider Active NPI

Kayleen Renee Vahle, RD

  • Registered Dietitian
  • Albuquerque, NM
National Provider Identifier
1720333875
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
542 Issued in NM
Practice address
1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453
Phone
(505) 844-4237
Fax
(505) 844-4091
NPI assigned
Jul 16, 2012
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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 542 NM Primary

Addresses

Primary practice location

1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453

Mailing address

1515 Eubank Blvd SE BLDG 831832
Albuquerque, NM 87123-3453
Phone (505) 844-4237

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

State licenses

LicenseStateTypeSpecialty
542NMMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1720333875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 EUBANK BLVD SE BLDG 831832",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233453",
            "telephone_number": "505-844-4237",
            "fax_number": "505-844-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 EUBANK BLVD SE BLDG 831832",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233453",
            "telephone_number": "505-844-4237",
            "fax_number": "505-844-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHLE",
        "first_name": "KAYLEEN",
        "middle_name": "RENEE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.