NPIMap

Individual provider Active NPI

Kristen Fustos, MS, RDN, CSP, LD,

  • Pediatric Nutrition Registered Dietitian
  • Tampa, FL
National Provider Identifier
1942078274
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
86118144 Issued in FL
Practice address
11274 W Hillsborough Ave
Tampa, FL 33635-9762
Phone
(813) 590-7565
Fax
(813) 219-8055
NPI assigned
Dec 15, 2023
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X ND9388 FL
Registered Dietitian 133V00000X 6210-29 WI
Registered Dietitian 133V00000X DT89444 TX
Registered Dietitian 133V00000X 5294 TN
Registered Dietitian 133V00000X 164.010167 IL
Pediatric Nutrition Registered Dietitian 133VN1004X 86118144 FL Primary

Addresses

Primary practice location

11274 W Hillsborough Ave
Tampa, FL 33635-9762

Mailing address

11274 W Hillsborough Ave
Tampa, FL 33635-9762
Phone (813) 590-7565

Other names 1

  • Kristen Gooch Former name

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ND9388FLMDNutritionist
164.010167ILMDRegistered Dietitian
5294TNMDRegistered Dietitian
DT89444TXMDRegistered Dietitian
6210-29WIMDRegistered Dietitian
86118144FLMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Tummy Nutrition, LLC Nutrition, Pediatric CurrentSince Nov 9, 2025 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Marathon Health LLC PastSince Sep 8, 2024 Accepting new patients
Keepcare LLC Dietitian, Registered Past Accepting new patients
Covered Technologies LLC Dietitian, Registered Past Accepting new patients

Organizations & group practices 5

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": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1942078274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11274 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359762",
            "telephone_number": "813-590-7565",
            "fax_number": "813-219-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11274 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336359762",
            "telephone_number": "813-590-7565",
            "fax_number": "813-219-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSTOS",
        "first_name": "KRISTEN",
        "credential": "MS, RDN, CSP, LD,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND9388",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "6210-29",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT89444",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "5294",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.010167",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "86118144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GOOCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.