Kimberly D Addison, RD

Individual provider Active NPI Registered Dietitian · Cullman, AL

NPI 1912995457 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1912995457
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
621278 (AL)
Practice address
1792 Al Highway 157
Cullman, AL 35058-3622
Phone
(256) 737-2025
Fax
(256) 737-2829
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cullman Internal Medicine, PC (28 clinicians)

Practice addresses (Care Compare)

1890 Al Hwy 157
Cullman, AL 35058-0689
Phone (256) 737-2100

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220728000268 AL Practitioner - Registered Dietitian Or Nutrition Professional 7416980974 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
621278ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cullman Internal Medicine, PC Current
since Jul 5, 2022
Accepting new patients
Diabetes Care Center Past Accepting new patients
Cullman Regional Medical Center, Inc Past Accepting new patients
Cullman Regional Medical Center Inc Past Accepting new patients

Locations

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

1890 AL Highway 157
Cullman, AL 35058
Phone (256) 737-8000

1890 AL Highway 157
Ste 300
Cullman, AL 35058
Phone (256) 737-2100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 621278 AL Yes

Addresses

Primary practice location

1792 Al Highway 157
Cullman, AL 35058-3622

Mailing address

1912 Al Highway 157
Cullman, AL 35058-0609
Phone (256) 737-2882

Other providers in Cullman, AL

All providers in Cullman, AL · Registered Dietitian in Alabama

Sources for this page

Verify at the official NPI Registry.