Kidney Nutrition Care Center LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

KIDNEY NUTRITION CARE CENTER LLC

Practice address

101 Wilkesboro St Ste a
Mocksville, NC 27028-2321

Phone

(336) 936-8169

Fax

(844) 440-1999

NPI assigned

Oct 18, 2022

Last updated

Feb 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy J Crotts, MS, RD, LDNNPI 1902042633

Title

President

Phone

(336) 817-8991

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathy Jones Crotts, MS, RD, LDN

  • Registered Dietitian
  • Mocksville, NC
  • NPI 1902042633
  Authorized official Same address or phone

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1851017123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 TOM CROTTS LN",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270285444",
            "telephone_number": "336-817-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILKESBORO ST STE A",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282321",
            "telephone_number": "336-936-8169",
            "fax_number": "844-440-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Saint George Square Ct Ste 300",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031368",
            "country_code": "US",
            "telephone_number": "336-817-8991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDNEY NUTRITION CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "CROTTS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-817-8991",
        "authorized_official_credential": "MS, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Jones
• Joshua's House
• Elizabeth Karels, M.A. CCC-SLP
• Kevin Chavez DMD - Mocksville, PLLC
• Kevin J. Armbrecht, D.D.S., P.a.
• Michael Warren Kilby, M.D.
• Haley Hwajeong Kim, DDS
• George Douglas Kimberly, M.D.
• Claire Grace King
• Jennifer Kmen, PHARM D

• Registered Dietitian in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.