Active NPI
Kyle Nicholas Craig, RD
- Registered Dietitian
- Long Beach, CA
National Provider Identifier
1730822065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86051860
- Practice address
- 5901 E 7TH St
Long Beach, CA 90822-5201 - Phone
- (562) 826-8000
- NPI assigned
- Apr 14, 2022
- Last updated
- Apr 14, 2022
- Sex
- Male
- 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 | 86051860 | CA | Primary |
Addresses
Primary practice location
5901 E 7TH St
Long Beach, CA 90822-5201
Mailing address
2176 Sullivan
Irvine, CA 92614-5028
Phone (702) 204-3679
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86051860 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1730822065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2176 SULLIVAN",
"city": "IRVINE",
"state": "CA",
"postal_code": "926145028",
"telephone_number": "702-204-3679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201",
"telephone_number": "562-826-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "KYLE",
"middle_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-14",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86051860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.