Active NPI
Kimberly Kay Rogers, RD LD N
- Registered Dietitian
- Fort Pierce, FL
National Provider Identifier
1932100294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND 1278
- Practice address
- 290 Sunrise Dr
Fort Pierce, FL 34945-4125 - Phone
- (772) 461-1349
- NPI assigned
- Aug 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND 1278 | FL | Primary |
Addresses
Primary practice location
290 Sunrise Dr
Fort Pierce, FL 34945-4125
Mailing address
290 Sunrise Dr
Fort Pierce, FL 34945-4125
Phone (772) 461-1349
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LD # ND1278 | Other | FL | LICENSED |
| RD 713403 | Other | FL | REGISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND 1278 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1932100294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 SUNRISE DR",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349454125",
"telephone_number": "772-461-1349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 SUNRISE DR",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349454125",
"telephone_number": "772-461-1349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGERS",
"first_name": "KIMBERLY",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "RD LD N",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-09",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND 1278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED",
"identifier": "LD # ND1278",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTRATION",
"identifier": "RD 713403",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.