Individual provider Active NPI

Kristen Lee Vanwormer, RD

  • Registered Dietitian
  • Avon, CT
National Provider Identifier
1992058630
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
6 Raymond Rd
Avon, CT 06001-3629
Phone
(860) 944-9776
Fax
(860) 735-6532
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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 Primary

Addresses

Primary practice location

6 Raymond Rd
Avon, CT 06001-3629

Mailing address

6 Raymond Rd
Avon, CT 06001-3629
Phone (860) 944-9776

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Medical Nutrition Therapy Associates LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1992058630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 RAYMOND RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013629",
            "telephone_number": "860-944-9776",
            "fax_number": "860-735-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RAYMOND RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013629",
            "telephone_number": "860-944-9776",
            "fax_number": "860-735-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWORMER",
        "first_name": "KRISTEN",
        "middle_name": "LEE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.