NPIMap

Individual provider Active NPI

Cristal Vardeman, RD

  • Registered Dietitian
  • Tyler, TX
National Provider Identifier
1942979018
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86152610 Issued in TX
Practice address
4411 Kinsey Dr Apt 1024
Tyler, TX 75703-1020
Phone
(903) 392-9705
Fax
(430) 267-3550
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86152610 TX Primary
Nutrition Education Nutritionist 133NN1002X
Nutritionist 133N00000X
Registered Dietitian 133V00000X

Addresses

Primary practice location

4411 Kinsey Dr Apt 1024
Tyler, TX 75703-1020

Mailing address

4411 Kinsey Dr Apt 1024
Tyler, TX 75703-1020
Phone (903) 392-9705

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://practicebetter.io/

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

LicenseStateTypeSpecialty
86152610TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Healthie Code Nutritionist CurrentSince Sep 20, 2021 Accepting new patients
MNT Associates LLC Dietitian, Registered CurrentSince Nov 23, 2024 Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

606 S Seven Points Dr
Ste 10
Seven Points, TX 75143
Phone (214) 432-5633

Organizations & group practices 4

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1942979018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 KINSEY DR APT 1024",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031020",
            "telephone_number": "903-392-9705",
            "fax_number": "430-267-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 KINSEY DR APT 1024",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031020",
            "telephone_number": "903-392-9705",
            "fax_number": "430-267-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDEMAN",
        "first_name": "CRISTAL",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86152610",
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://practicebetter.io/",
            "affiliation": "N",
            "address_1": "4411 Kinsey Dr Apt 1024",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757031020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.