KMM Nutrition Services LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

KMM NUTRITION SERVICES LLC

Practice address

67 VT Route 5a
West Burke, VT 05871-4415

Phone

(802) 227-2585

NPI assigned

Jun 10, 2024

Last updated

Jan 13, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelsey McCullough, RDN, LDNNPI 1912477019

Title

Owner

Phone

(603) 991-7996

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelsey McCullough, RD, LD

  • Registered Dietitian
  • West Burke, VT
  • NPI 1912477019

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1922840024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 VT ROUTE 5A",
            "city": "WEST BURKE",
            "state": "VT",
            "postal_code": "058714415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 VT ROUTE 5A",
            "city": "WEST BURKE",
            "state": "VT",
            "postal_code": "058714415",
            "telephone_number": "802-227-2585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "NH",
            "postal_code": "035843041",
            "country_code": "US",
            "telephone_number": "802-227-2585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KMM NUTRITION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-991-7996",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Allard, RN
• Jennifer Dubuque, PLLC
• Katherine Goetz Licsw LLC
• Kristine Kellar, LMHC
• Kelsey McCullough, RD, LD
• Kadienne Whitcomb

• Registered Dietitian in West Burke, VT
• Providers in West Burke, VT by specialty
• Registered Dietitian in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.