Active NPI
Kristine Carlson Bonham, RDN
- Registered Dietitian
- Charlottesville, VA
National Provider Identifier
1972029296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 647296
- Practice address
- 875 Rio East CT
Charlottesville, VA 22901-8004 - Phone
- (434) 242-2935
- NPI assigned
- Aug 17, 2017
- 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 | 647296 | NE | Primary |
Addresses
Primary practice location
875 Rio East CT
Charlottesville, VA 22901-8004
Mailing address
2200 Lanford Hills Dr
Charlottesville, VA 22911-9100
Phone (434) 242-2935
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
| License | State | Type | Specialty |
|---|---|---|---|
| 647296 | NE | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502928000000",
"number": "1972029296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 LANFORD HILLS DR",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229119100",
"telephone_number": "434-242-2935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 RIO EAST CT",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229018004",
"telephone_number": "434-242-2935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONHAM",
"first_name": "KRISTINE",
"middle_name": "CARLSON",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2017-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "647296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.