Active NPI
Kelly Vanallen-Braswell, RD
- Registered Dietitian
- Kinderhook, NY
National Provider Identifier
1962671149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 006035-1
- Practice address
- 5 Rothermel Ave
Kinderhook, NY 12106-2105 - Phone
- (518) 758-8885
- NPI assigned
- Feb 21, 2008
- Last updated
- Feb 21, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 006035-1 | NY | Primary |
Addresses
Primary practice location
5 Rothermel Ave
Kinderhook, NY 12106-2105
Mailing address
PO Box 3
Kinderhook, NY 12106-0003
Phone (518) 758-8885
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 |
|---|---|---|---|
| 006035-1 | NY | MD | Acupuncturist |
| 006035 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kinderhook Nutrition, LLC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1962671149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3",
"city": "KINDERHOOK",
"state": "NY",
"postal_code": "121060003",
"telephone_number": "518-758-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 ROTHERMEL AVE",
"city": "KINDERHOOK",
"state": "NY",
"postal_code": "121062105",
"telephone_number": "518-758-8885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANALLEN-BRASWELL",
"first_name": "KELLY",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-21",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "006035-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kinderhook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.