Active NPI
Kimberly V Terrell, RD
- Registered Dietitian
- Clayton, GA
National Provider Identifier
1841569993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD002241
- Practice address
- 196 Ridgecrest Cir
Clayton, GA 30525-4111 - Phone
- (706) 782-4233
- Fax
- (706) 782-6451
- NPI assigned
- Dec 19, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD002241 | GA | Primary |
Addresses
Primary practice location
196 Ridgecrest Cir
Clayton, GA 30525-4111
Mailing address
5303 Vaughn Rd
Montgomery, AL 36116-1120
Phone (334) 386-0378
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002241 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1841569993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5303 VAUGHN RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361161120",
"telephone_number": "334-386-0378",
"fax_number": "337-386-0382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 RIDGECREST CIR",
"city": "CLAYTON",
"state": "GA",
"postal_code": "305254111",
"telephone_number": "706-782-4233",
"fax_number": "706-782-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRELL",
"first_name": "KIMBERLY",
"middle_name": "V",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD002241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.