Individual provider Active NPI

Stacey Kirkpatrick, RD

  • Registered Dietitian
  • Grapevine, TX
National Provider Identifier
1942723259
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT84513 Issued in TX
Practice address
1701 W Northwest Hwy
Grapevine, TX 76051-8127
Phone
(682) 651-8581
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 DT84513 TX Primary

Addresses

Primary practice location

1701 W Northwest Hwy
Grapevine, TX 76051-8127

Mailing address

1000 Ownby LN
Southlake, TX 76092-6331
Phone (214) 693-2657

Other practice location 1

1000 Ownby Ln
Southlake, TX 76092-6331
Phone (214) 693-2657

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

State licenses

LicenseStateTypeSpecialty
DT84513TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1942723259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OWNBY LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926331",
            "telephone_number": "214-693-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W NORTHWEST HWY",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518127",
            "telephone_number": "682-651-8581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Ownby Ln",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926331",
            "country_code": "US",
            "telephone_number": "214-693-2657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "STACEY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT84513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.