Active NPI
Karen L Vidal, M.S., R.D.
- Registered Dietitian
- Greensboro, GA
National Provider Identifier
1780867549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD001664
- Practice address
- 6350 Lake Oconee Pkwy
Suite 102, PMB 89
Greensboro, GA 30642-6433 - Phone
- (706) 485-1298
- NPI assigned
- Dec 14, 2007
- Last updated
- Jan 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD001664 | GA | Primary |
Addresses
Primary practice location
6350 Lake Oconee Pkwy
Suite 102, PMB 89
Greensboro, GA 30642-6433
Mailing address
6350 Lake Oconee Pkwy
Suite 102, PMB 89
Greensboro, GA 30642-6433
Phone (706) 485-1298
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD001664 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389052800000",
"number": "1780867549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6350 LAKE OCONEE PKWY",
"address_2": "SUITE 102, PMB 89",
"city": "GREENSBORO",
"state": "GA",
"postal_code": "306426433",
"telephone_number": "706-485-1298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6350 LAKE OCONEE PKWY",
"address_2": "SUITE 102, PMB 89",
"city": "GREENSBORO",
"state": "GA",
"postal_code": "306426433",
"telephone_number": "706-485-1298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDAL",
"first_name": "KAREN",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "M.S., R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-14",
"last_updated": "2014-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD001664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.