Active NPI
Kelli A Wimberly, RD
- Registered Dietitian
- Lake Charles, LA
National Provider Identifier
1992768428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1717
- Practice address
- 524 S Ryan St
Lake Charles, LA 70601-5725 - Phone
- (337) 430-5448
- NPI assigned
- Apr 7, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 1717 | LA | Primary |
Addresses
Primary practice location
524 S Ryan St
Lake Charles, LA 70601-5725
Mailing address
1701 21St St
Lake Charles, LA 70601-8941
Phone (337) 479-6056
Other names 1
- Kelli J Abboud
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 |
|---|---|---|---|
| 1717 | LA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sodexo Operations 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1992768428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 21ST ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706018941",
"telephone_number": "337-479-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "524 S RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706015725",
"telephone_number": "337-430-5448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBERLY",
"first_name": "KELLI",
"middle_name": "A",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "1717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLI",
"last_name": "ABBOUD",
"middle_name": "J",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.