Kirsten Nicole Mellott, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86154717 Issued in AZ

Practice address

155 Calle Portal Ste 700
Sierra Vista, AZ 85635-2973

Phone

(520) 459-0203

Fax

(520) 459-3159

NPI assigned

Jul 21, 2021

Last updated

Jul 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kirsten Nicole Anderson Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiricahua Community Health Centers IncGroup PAC ID 5395638878, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kirsten.mellott.1@20478.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chiricahua Community Health Centers, Inc

  dba Business Office

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443
  Medicare reassignment Care Compare group NPD
• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Sierra Vista, AZ
  • NPI 1821309089
  NPD
• Chiricahua Community Health Centers, Inc.

  dba Willcox Clinic

  • Federally Qualified Health Center (FQHC)
  • Willcox, AZ
  • NPI 1285488866
  NPD

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1891368452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-1429",
            "fax_number": "520-515-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL STE 700",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352973",
            "telephone_number": "520-459-0203",
            "fax_number": "520-459-3159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2585 E Wilcox Dr",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856352821",
            "country_code": "US",
            "telephone_number": "520-255-5475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "496 Earl Dr",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856351132",
            "country_code": "US",
            "telephone_number": "801-874-5856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "KIRSTEN",
        "middle_name": "NICOLE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86154717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "ANDERSON",
            "middle_name": "NICOLE",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael McLaughlin, M.D.
• MD Med Inc (Sierra Vista Cancer Center)
• Medlink1 LLC
• Scott J Megna, M.D.
• Jessica Lynn Meinhardt
• Menla Acupuncture and Oriental Medicine PLLC
• Mentally Ill Kids in Distress (Mikid)
• David Andrew Merrell, PHARM.D
• Kara Joy Merrell, FNP
• Deanna Lee Merrill, RN, CNP

• Registered Dietitian in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.