Individual provider Active NPI

Kimberly Sue Hyatt, RD, LDN

  • Registered Dietitian
  • Easton, MD
National Provider Identifier
1740562503
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX3169 Issued in MD
Practice address
219 S Washington St
Easton, MD 21601-2913
Phone
(410) 822-1000
Fax
(410) 819-0989
NPI assigned
Sep 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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 DX3169 MD Primary

Addresses

Primary practice location

219 S Washington St
Easton, MD 21601-2913

Mailing address

219 S Washington St
Easton, MD 21601-2913
Phone (410) 822-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160609002383 DE Practitioner - Registered Dietitian Or Nutrition Professional 5496045064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beebe Physician Network Inc.Group PAC ID 5496744864, 301 clinicians

Practice addresses (Care Compare)

21635 Biden Ave
Georgetown, DE 19947-4574
Phone (302) 260-7360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DX3169MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Physician Network, Inc. CurrentSince May 23, 2016 Accepting new patients
Beebe Physician Network Inc. CurrentSince Jun 19, 2021 Accepting new patients
State of Delaware-Stockley CurrentSince Jun 19, 2021 Accepting new patients

Locations

21635 Biden Ave
Unit 205
Georgetown, DE 19947

21635 Biden Ave
Unit 203
Georgetown, DE 19947
Phone (302) 260-7360

32550 Docs Pl
Unit 2
Millville, DE 19967
Phone (302) 539-4302

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

8472 Herring Run Rd
Seaford, DE 19973
Phone (302) 297-2510

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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1740562503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S WASHINGTON ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012913",
            "telephone_number": "410-822-1000",
            "fax_number": "410-819-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S WASHINGTON ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012913",
            "telephone_number": "410-822-1000",
            "fax_number": "410-819-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.