Active NPI
Kaylie Chrismon Teague, MS, RDN, LDN
- Registered Dietitian
- Winston Salem, NC
National Provider Identifier
1881252864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L004906
- Practice address
- 1 Medical Center Boulevard
Winston Salem, NC 27157-0001 - Phone
- (336) 713-3058
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L004906 | NC | Primary |
Addresses
Primary practice location
1 Medical Center Boulevard
Winston Salem, NC 27157-0001
Mailing address
5250 Mountain View Rd
Winston Salem, NC 27104-5116
Phone (336) 391-4587
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86026733 | Other | COMMISSION ON DIETETIC REGISTRATION | |
| L004906 | Other | NC | NORTH CAROLINA BOARD OF DIETETICS/NUTRITION |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kteague@wakehealth.edu | Direct | Wake Forest Baptist Health |
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
| License | State | Type | Specialty |
|---|---|---|---|
| L004906 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1881252864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5250 MOUNTAIN VIEW RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271045116",
"telephone_number": "336-391-4587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER BOULEVARD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-713-3058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAGUE",
"first_name": "KAYLIE",
"middle_name": "CHRISMON",
"name_prefix": "Mrs.",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L004906",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "86026733",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA BOARD OF DIETETICS/NUTRITION",
"identifier": "L004906",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kteague@wakehealth.edu",
"affiliation": "Y",
"endpointDescription": "Encrypted work email.",
"affiliationName": "Wake Forest Baptist Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Medical Center Boulevard",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271570001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.