Individual provider Active NPI

Heather Diane Kirkover, RD, LD

  • Registered Dietitian
  • Clayton, MO
National Provider Identifier
1982371811
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2019016831 Issued in MO
Practice address
230 S Bemiston Ave Ste 430
Clayton, MO 63105-1907
Phone
(314) 530-7400
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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 2019016831 MO Primary

Addresses

Primary practice location

230 S Bemiston Ave Ste 430
Clayton, MO 63105-1907

Mailing address

11925 Big Bend Rd
Saint Louis, MO 63122-5554
Phone (618) 792-3635

Other names 1

  • Heather Diane Young Other name

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

LicenseStateTypeSpecialty
2019016831MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
McDaniel Nutrition Therapy, LLC Dietitian, Registered CurrentSince Aug 29, 2021 Accepting new patients

Locations

230 S Bemiston Ave
Ste 430
Saint Louis, MO 63105
Phone (314) 413-1996

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1982371811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11925 BIG BEND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631225554",
            "telephone_number": "618-792-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S BEMISTON AVE STE 430",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051907",
            "telephone_number": "314-530-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKOVER",
        "first_name": "HEATHER",
        "middle_name": "DIANE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2019016831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "YOUNG",
            "middle_name": "DIANE",
            "credential": "RD, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.