Active NPI
Keri Ann Souza, RD, LD
- Registered Dietitian
- Phenix City, AL
National Provider Identifier
1740036128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 810689
- Practice address
- 13 Wally LN
Phenix City, AL 36867-7329 - Phone
- (803) 542-2734
- NPI assigned
- Apr 26, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5424 | AL | |
| Registered Dietitian | 133V00000X | 810689 | Primary |
Addresses
Primary practice location
13 Wally LN
Phenix City, AL 36867-7329
Mailing address
13 Wally LN
Phenix City, AL 36867-7329
Phone (803) 542-2734
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": "1714089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1740036128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 WALLY LN",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368677329",
"telephone_number": "803-542-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 WALLY LN",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368677329",
"telephone_number": "803-542-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "KERI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-26",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "5424",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": "810689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phenix City, AL
- Ryan Smith, PHARMD
- Samantha Smith
- Caitlyn Erin Snipes
- Solace Expressions, LLC
- Southeastern Home Oxygen Service, Inc.
- Christa D Spann, D.M.D.
- Vernissa Alanna Sparks, RN
- State of Alabama
- State of Alabama Department of Public Health (Russell County Home Care)
- State of Alabama Department of Public Health (Russell County Home Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.