Individual provider Active NPI

Rick Loudermelt, RPH, DPH, RD, LD

  • Registered Dietitian
  • Williamsburg, KY
National Provider Identifier
1760654073
Registry record updated Nov 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2083 Issued in KY
Practice address
475 N Highway 25 W
Williamsburg, KY 40769-1576
Phone
(606) 215-6352
Fax
(877) 792-5105
NPI assigned
Mar 26, 2008
Last updated
Nov 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2083 KY Primary
Pharmacist 183500000X 12304 KY
Pharmacist 183500000X 11957 TN
Pharmacist 183500000X 12249 AL

Addresses

Primary practice location

475 N Highway 25 W
Williamsburg, KY 40769-1576

Mailing address

PO Box 698
Williamsburg, KY 40769-0698
Phone (606) 215-6352

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)
Enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
11957TNMDGeneral Practice Dentistry
12249ALMDPharmacist
12304KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Corner Prescription Shoppe Inc PastSince Apr 1, 2013 Accepting new patients
RL Nutrition Services PastSince Jan 1, 1990 Accepting new patients

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": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290902400000",
    "number": "1760654073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407690698",
            "telephone_number": "606-215-6352",
            "fax_number": "877-792-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691576",
            "telephone_number": "606-215-6352",
            "fax_number": "877-792-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUDERMELT",
        "first_name": "RICK",
        "credential": "RPH, DPH, RD, LD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-26",
        "last_updated": "2010-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "2083",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "12304",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "11957",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "12249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2010; 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.