Individual provider Active NPI

Kimberly D Addison, RD

  • Registered Dietitian
  • Cullman, AL
National Provider Identifier
1912995457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
621278 Issued in AL
Practice address
1792 Al Highway 157
Cullman, AL 35058-3622
Phone
(256) 737-2025
Fax
(256) 737-2829
NPI assigned
Oct 10, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 621278 AL Primary

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

Medicare participation

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

Enrollment records 1

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

Care Compare profile

Medicare Care Compare
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, PCGroup PAC ID 2365354339, 28 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
621278ALMDRegistered Dietitian

Practice roles

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

Locations

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912995457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2882",
            "fax_number": "256-737-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350583622",
            "telephone_number": "256-737-2025",
            "fax_number": "256-737-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AL",
            "license": "621278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.