Individual provider Active NPI

Kimberly Jane Dryer, RDN, LD

  • Registered Dietitian
  • Fort Worth, TX
National Provider Identifier
1891568366
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT87830 Issued in TX
Practice address
2201 SE Loop 820
Fort Worth, TX 76119-5863
Phone
(800) 443-9672
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 DT87830 TX Primary

Addresses

Primary practice location

2201 SE Loop 820
Fort Worth, TX 76119-5863

Mailing address

837 Rio Grande Dr
Mansfield, TX 76063-6384
Phone (812) 577-6249

Other names 1

  • Kimberly Jane Dryer Other name

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

State licenses

LicenseStateTypeSpecialty
DT87830TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1891568366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 RIO GRANDE DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636384",
            "telephone_number": "812-577-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SE LOOP 820",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761195863",
            "telephone_number": "800-443-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYER",
        "first_name": "KIMBERLY",
        "middle_name": "JANE",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT87830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DRYER",
            "middle_name": "JANE",
            "credential": "RDN, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.