Individual provider Active NPI

Kelly Cleerdin Barrett, RDN, LDN

  • Registered Dietitian
  • Cumming, GA
National Provider Identifier
1760013734
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD007209 Issued in GA
Practice address
1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone
(770) 844-3200
NPI assigned
Jan 29, 2020
Last updated
Aug 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD007209 GA Primary
Registered Dietitian 133V00000X LD007209 FL

Addresses

Primary practice location

1200 Northside Forsyth Dr
Cumming, GA 30041-7659

Mailing address

171 9TH Dr
Vero Beach, FL 32962-2815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220709000634 FL Practitioner - Registered Dietitian Or Nutrition Professional 2264812163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD007209FLMDRegistered Dietitian
LD007209GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Jun 27, 2022 Accepting new patients
Indian River Health Services Inc CurrentSince Jun 27, 2022 Accepting new patients

Locations

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

1000 36th St
Ste 5105
Vero Beach, FL 32960

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4444

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 2

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1760013734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 9TH DR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329622815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "KELLY",
        "middle_name": "CLEERDIN",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD007209",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "LD007209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.