Kayla Jimerson, RDN
Individual provider Active NPI Registered Dietitian · Nathrop, CO
NPI 1861003402 · NPPES record last updated Aug 16, 2020
Key facts
- NPI
- 1861003402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86169085 (CO)
- Practice address
- 11240 County Road 198
Nathrop, CO 81236-9733 - Phone
- (970) 580-4468
- NPI assigned
- Aug 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86169085 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86169085 | CO | Yes |
Addresses
Primary practice location
11240 County Road 198
Nathrop, CO 81236-9733
Mailing address
11240 County Road 198
Nathrop, CO 81236-9733
Phone (970) 580-4468
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.