Individual provider Active NPI

Kaitlyn Nace, RDN, LDN

  • Registered Dietitian
  • Kingsport, TN
National Provider Identifier
1902687155
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3880 Issued in TN
Practice address
2752 Edinburgh Channel Rd
Kingsport, TN 37664-5674
Phone
(423) 946-0977
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 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 3880 TN Primary

Addresses

Primary practice location

2752 Edinburgh Channel Rd
Kingsport, TN 37664-5674

Mailing address

2752 Edinburgh Channel Rd
Kingsport, TN 37664-5674
Phone (423) 946-0977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509001448 TN Practitioner - Registered Dietitian Or Nutrition Professional 8123545415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
East Tennessee State University Quillen College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Kidney Care PCGroup PAC ID 5597728527, 8 clinicians

Practice addresses (Care Compare)

2002 Brookside Dr
Suite 102
Kingsport, TN 37660-4634
Phone 4232456000211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3880TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Kidney Care, PC CurrentSince Apr 29, 2025 Accepting new patients

Locations

2002 Brookside Dr
Ste 102
Kingsport, TN 37660
Phone (423) 245-6000

Interoperability endpoints

  • Direct secure messaging: knace77133@direct.acumenmd.com

Organizations & group practices 1

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": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1902687155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2752 EDINBURGH CHANNEL RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376645674",
            "telephone_number": "423-946-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2752 EDINBURGH CHANNEL RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376645674",
            "telephone_number": "423-946-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACE",
        "first_name": "KAITLYN",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "3880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.