Kristen Green, MDS, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1941 Keese Sagebiel Rd
Fredericksburg, TX 78624-6987

Phone

(830) 998-0061

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Kristen Keith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972238061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 KEESE SAGEBIEL RD",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786246987",
            "telephone_number": "830-998-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 KEESE SAGEBIEL RD",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786246987",
            "telephone_number": "830-998-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KRISTEN",
        "credential": "MDS, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KEITH",
            "credential": "MDS, RDN, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gillespie County Committee on Aging
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• Greater Hill Country Hospice
• Ralph Gillespie Greenlee Jr., MD
• Gregory D. Andreassian M.D., P.a.
• Edwin Fred Grimes Jr., D.D.S.
• Traci Grona, RN
• Grow and Let Go Therapy Practice

• Registered Dietitian in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.