Individual provider Active NPI

Kirsten Adamson

  • Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1952701013
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
CDR86045308 Issued in AZ
Practice address
3830 E Van Buren St
Phoenix, AZ 85008-6920
Phone
(602) 243-7277
Fax
(602) 286-0808
NPI assigned
Aug 26, 2014
Last updated
Nov 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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 CDR86045308 AZ Primary

Addresses

Primary practice location

3830 E Van Buren St
Phoenix, AZ 85008-6920

Mailing address

2702 N 3Rd St
Suite 4020
Phoenix, AZ 85004-1130
Phone (602) 323-3345

Other identifiers 1

IdentifierTypeStateIssuer
946962MedicaidAZ

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
CDR86045308AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Past Accepting new patients
Mountain Park Health Center Past Accepting new patients

Organizations & group practices 2

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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1952701013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 N 3RD ST",
            "address_2": "SUITE 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041130",
            "telephone_number": "602-323-3345",
            "fax_number": "602-323-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 E VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086920",
            "telephone_number": "602-243-7277",
            "fax_number": "602-286-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMSON",
        "first_name": "KIRSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "CDR86045308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "946962",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.