Heather D McKenzie, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2612 Issued in LA

Practice address

113 Hilton Head Dr
Benton, LA 71006-8425

Phone

(972) 672-6392

NPI assigned

Jul 1, 2008

Last updated

Nov 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1942462874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HILTON HEAD DR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710068425",
            "telephone_number": "726-726-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HILTON HEAD DR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710068425",
            "telephone_number": "972-672-6392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Central Expy N",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750136103",
            "country_code": "US",
            "telephone_number": "972-747-6149",
            "fax_number": "972-747-6086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "HEATHER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT80341",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "2612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Benton, LA
• Providers in Benton, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.