Individual provider Active NPI

Katelyn A Willbur, RD/N, LD/N

  • Registered Dietitian
  • West Palm Beach, FL
National Provider Identifier
1760936454
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND 7913 Issued in FL
Practice address
300 Valley Forge Rd
West Palm Beach, FL 33405-4016
Phone
(561) 352-9825
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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 ND 7913 FL Primary

Addresses

Primary practice location

300 Valley Forge Rd
West Palm Beach, FL 33405-4016

Mailing address

300 Valley Forge Rd
West Palm Beach, FL 33405-4016

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

State licenses

LicenseStateTypeSpecialty
ND 7913FLMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1760936454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VALLEY FORGE RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334054016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VALLEY FORGE RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334054016",
            "telephone_number": "561-352-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBUR",
        "first_name": "KATELYN",
        "middle_name": "A",
        "credential": "RD/N, LD/N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 7913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.