Individual provider Active NPI

Kayla Reidhead

  • Registered Dietitian
  • New Braunfels, TX
National Provider Identifier
1790397297
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86402 Issued in TX
Practice address
66 Gruene Park Dr Ste 210
New Braunfels, TX 78130-2219
Phone
(830) 730-4375
Fax
(830) 730-4203
NPI assigned
Aug 18, 2020
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 DT86402 TX Primary

Addresses

Primary practice location

66 Gruene Park Dr Ste 210
New Braunfels, TX 78130-2219

Mailing address

66 Gruene Park Dr Ste 210
New Braunfels, TX 78130-2219
Phone (830) 730-4375

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

State licenses

LicenseStateTypeSpecialty
DT86402TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1790397297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 GRUENE PARK DR STE 210",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302219",
            "telephone_number": "830-730-4375",
            "fax_number": "830-730-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 GRUENE PARK DR STE 210",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302219",
            "telephone_number": "830-730-4375",
            "fax_number": "830-730-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDHEAD",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.