Individual provider Active NPI

Kristen Elledge Andrews, RD, LDN

  • Registered Dietitian
  • Winston Salem, NC
National Provider Identifier
1902159130
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004063 Issued in NC
Practice address
1400 Westgate Center Dr Ste 110
Winston Salem, NC 27103-3104
Phone
(336) 277-1660
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 L004063 NC Primary

Addresses

Primary practice location

1400 Westgate Center Dr Ste 110
Winston Salem, NC 27103-3104

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000022 NC Practitioner - Registered Dietitian Or Nutrition Professional 0648415810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1710 Kernersville Medical Pkwy
Suite 210
Kernersville, NC 27284-7157
Phone (336) 564-4065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L004063NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Dec 3, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Medical Group, Inc. CurrentSince Dec 3, 2021 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 220
Charlotte, NC 28207
Phone (704) 316-1125

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

5175 Old Clemmons School Rd
Clemmons, NC 27012
Phone (336) 718-3960

1710 Kernersville Medical Pkwy
Ste 210
Kernersville, NC 27284
Phone (336) 564-4065

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

903 Randolph St
Thomasville, NC 27360
Phone (336) 475-7163

2001 Todays Woman Ave
Winston Salem, NC 27105
Phone (336) 722-1818

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

1351 Westgate Center Dr
Winston Salem, NC 27103
Phone (336) 718-7777

1350 Whitaker Ridge Dr
Winston Salem, NC 27106
Phone (336) 718-8000

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1902159130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WESTGATE CENTER DR STE 110",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033104",
            "telephone_number": "336-277-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "KRISTEN",
        "middle_name": "ELLEDGE",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Apr 5, 2022; 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.