Active NPI
Kristine Boothe, RDN
- Registered Dietitian
- MC Leansville, NC
National Provider Identifier
1831080357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L008766
- Practice address
- 5460 Smiley Wyrick Rd
MC Leansville, NC 27301-9728 - Phone
- (585) 406-4991
- NPI assigned
- Jul 12, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86391804 | ||
| Registered Dietitian | 133V00000X | DT92367 | TX | |
| Registered Dietitian | 133V00000X | L008766 | NC | Primary |
Addresses
Primary practice location
5460 Smiley Wyrick Rd
MC Leansville, NC 27301-9728
Mailing address
5460 Smiley Wyrick Rd
MC Leansville, NC 27301-9728
Phone (585) 406-4991
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
| License | State | Type | Specialty |
|---|---|---|---|
| L008766 | NC | MD | Registered Dietitian |
| DT92367 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KB Nutrition, LLC | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755388800000",
"number": "1831080357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5460 SMILEY WYRICK RD",
"city": "MC LEANSVILLE",
"state": "NC",
"postal_code": "273019728",
"telephone_number": "585-406-4991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5460 SMILEY WYRICK RD",
"city": "MC LEANSVILLE",
"state": "NC",
"postal_code": "273019728",
"telephone_number": "585-406-4991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTHE",
"first_name": "KRISTINE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-12",
"last_updated": "2025-08-17",
"certification_date": "2025-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86391804",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT92367",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L008766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Leansville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.