Individual provider Active NPI

Rita Hebblethwaite, RDN

  • Registered Dietitian
  • Hattiesburg, MS
National Provider Identifier
1861045247
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D2166 Issued in MS
Practice address
5909 U S Highway 49 Ste 30
Hattiesburg, MS 39402-2860
Phone
(601) 296-2780
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D2166 MS Primary

Addresses

Primary practice location

5909 U S Highway 49 Ste 30
Hattiesburg, MS 39402-2860

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711002806 MS Practitioner - Registered Dietitian Or Nutrition Professional 4082159256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D2166MSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jun 24, 2024 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jun 24, 2024 Accepting new patients

Locations

5909 U S Highway 49
Ste 30
Hattiesburg, MS 39402
Phone (601) 296-2780

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1861045247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-264-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 U S HIGHWAY 49 STE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022860",
            "telephone_number": "601-296-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBBLETHWAITE",
        "first_name": "RITA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D2166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.