Kimberly M Hagenbuch, MS, RD, LDN, CDCES

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN003575 Issued in PA

Practice address

183 Log Pond Dr
Horsham, PA 19044-1978

Phone

(215) 813-5702

NPI assigned

Mar 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1790956852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 LOG POND DR",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190441978",
            "telephone_number": "215-813-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 LOG POND DR",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190441978",
            "telephone_number": "215-813-5702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Pheasant Run",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189401886",
            "country_code": "US",
            "telephone_number": "215-867-4717",
            "fax_number": "215-689-3183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGENBUCH",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MS, RD, LDN, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Michael Grasso, MD
• John F. Gregory, PHD
• Jesse Greiner, MSN, CRNP, FNP-C
• Chitra Lekha Gupta, MD
• Tracy Hafer, SLP
• Eva Haldis, RD
• Mary A Hall, RN
• Paul Halpern, M.ED
• Latrice Hambright, MA, LPC, CAADC, CCDP
• Katelyn Nicole Hann

• Registered Dietitian in Horsham, PA
• Providers in Horsham, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.