Kimberly Ross, DCN, CNS, CDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND9114 Issued in FL

Practice address

1201 6TH Ave W
Bradenton, FL 34205-7400

Phone

(941) 234-4541

Fax

(941) 213-5822

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1881116853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 DATE PALM LN",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342224316",
            "telephone_number": "941-234-4541",
            "fax_number": "941-213-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342057400",
            "telephone_number": "941-234-4541",
            "fax_number": "941-213-5822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 Genesee St",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "NY",
            "postal_code": "135015942",
            "country_code": "US",
            "telephone_number": "877-510-5562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17409 Detroit Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "OH",
            "postal_code": "441073427",
            "country_code": "US",
            "telephone_number": "877-510-5562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DCN, CNS, CDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "OH",
            "license": "LD.10482",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX6749",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND9114",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.008863",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "008524",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND9114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Joy Rosen, FDN-P
• Rosenkrans Physical Therapy
• Mark Lee Rosenthal, M.D.
• Zoe Ross-Nash
• Hannah Ross
• Nicholas Guy Ross, DO
• Pamela Susan Ross
• Alex Roth, DO
• Caroline M. Roth, APRN
• Diana Elizabeth Rothauser, P.T.

• Registered Dietitian in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.