Kristin Dickhoner Brandstetter, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD003243 Issued in GA

Practice address

4986 N Adams Rd
Suite E
Rochester, MI 48306-5017

Phone

(248) 475-4701

NPI assigned

Jan 9, 2008

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

Other identifiers 4

Other names 1

• Kristin Anne Dickhoner Other name

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1750566634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4986 N ADAMS RD",
            "address_2": "SUITE E",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483065017",
            "telephone_number": "248-475-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 N ADAMS RD",
            "address_2": "SUITE E",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483065017",
            "telephone_number": "248-475-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDSTETTER",
        "first_name": "KRISTIN",
        "middle_name": "DICKHONER",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105814858D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105814858C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105814858A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105814858B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DICKHONER",
            "middle_name": "ANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Registered Dietitian in Rochester, MI
• Providers in Rochester, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.