Individual provider Active NPI

Kristine R Spence, MS, RD, CD

  • Registered Dietitian
  • Murray, UT
National Provider Identifier
1871822171
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
978963 Issued in UT
Practice address
5848 Fashion Blvd
Murray, UT 84107-6121
Phone
(801) 314-4040
Fax
(801) 314-4043
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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 978963 UT Primary

Addresses

Primary practice location

5848 Fashion Blvd
Murray, UT 84107-6121

Mailing address

5848 Fashion Blvd
Murray, UT 84107-6121
Phone (801) 314-4040

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
978963UTMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1871822171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076121",
            "telephone_number": "801-314-4040",
            "fax_number": "801-314-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076121",
            "telephone_number": "801-314-4040",
            "fax_number": "801-314-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "KRISTINE",
        "middle_name": "R",
        "credential": "MS, RD, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "978963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.