Active NPI
Kelly A Flores, RD, LD
- Registered Dietitian
- Mission, TX
National Provider Identifier
1952462277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT04934
- Practice address
- 1814 Crown Pointe Blvd
Mission, TX 78572-3167 - Phone
- (956) 451-1771
- NPI assigned
- Dec 12, 2006
- Last updated
- Sep 2, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT 04934 | TX | |
| Registered Dietitian | 133V00000X | DT04934 | TX | Primary |
Addresses
Primary practice location
1814 Crown Pointe Blvd
Mission, TX 78572-3167
Mailing address
1814 Crown Pointe Blvd
Mission, TX 78572-3167
Phone (956) 451-1771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DT 04934 | Other | TX | STATE LICENSE |
Other names 1
- Miss Kelly A Rodriguez
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 |
|---|---|---|---|
| DT 04934 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCMJ Medical Management Services Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Medical Management Services
- Case Management Agency
- San Juan, TX
- NPI 1831129196
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1952462277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 CROWN POINTE BLVD",
"city": "MISSION",
"state": "TX",
"postal_code": "785723167",
"telephone_number": "956-451-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 CROWN POINTE BLVD",
"city": "MISSION",
"state": "TX",
"postal_code": "785723167",
"telephone_number": "956-451-1771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "KELLY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT 04934",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT04934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "DT 04934",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "RODRIGUEZ",
"middle_name": "A",
"prefix": "MISS",
"credential": "RD, LD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.