KAITLIN DETTRA (NPI# 1609437789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609437789 |
| Entity Type | Individual |
| Full Name | KAITLIN DETTRA |
| Credential | RD, LDN |
| Practice Address |
283 Second Street Pike Ste 145 Southampton PA 18966-3869 |
| Mailing Address |
484 Silver Ave Southampton PA 18966-3541 |
| Practice Telephone | 2153222213 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DN005331 | PA | Dietary & Nutritional Service Providers |
| Street Address |
283 SECOND STREET PIKE STE 145 |
| City | SOUTHAMPTON |
| State | PA |
| Zip Code | 18966-3869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144723677 | Butterwick & Kerner Associates, LLC | Internal Medicine | 283 Second Street Pike Ste 145, Southampton, PA 18966-3869 | 2018-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033758636 | Nancy Rubin | Speech-Language Pathologist | Nancy Rubin, 32 Brook Drive, Southampton, PA 18966 | 2019-12-30 |
| 1265970669 | Dominic Bogucki | Specialist/Technologist | 75 Meadowfield Dr, Southampton, PA 18966 | 2017-02-06 |
| 1518404359 | Amanda Phillips | Social Worker | 504 Lakeside Office Park, Suite 504, Southampton, PA 18966 | 2017-01-31 |
| 1386988830 | Sara Beth Bergman | Occupational Therapy Assistant | 1354 Hi View Drive, Southampton, PA 18966 | 2012-11-22 |
| 1326325523 | Annie Varughese | Pharmacist | 139 Lark Dr, Holland, PA 18966 | 2011-11-16 |
| 1912284993 | Christine Renee Nichols | Social Worker | 1030 Second Street Pike, Southampton, PA 18966 | 2011-11-04 |
| 1407134125 | Apex Smiles LLC | Dentist | 771 2nd Street Pike, Southampton, PA 18966 | 2011-07-29 |
| 1790092708 | The Comprehensive Learning Center, Inc. | Community/Behavioral Health | 150 James Way, Southampton, PA 18966 | 2010-09-13 |
| 1861713786 | Austin Patrick Daly | Dentist | 404 Lakeside Park, Southampton, PA 18966 | 2010-06-15 |
| 1164660015 | Andrew J Sohl | Podiatrist | 86 Buck Rd Ste 2, Southampton, PA 18966 | 2009-01-30 |
| Find all providers in zip 18966 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851876379 | Elena Brodsky | Dietitian, Registered | 63 Nelson Dr, Southampton, PA 18966-1542 | 2018-10-01 |
| 1063993301 | Lucrezia Scarampi | Dietitian, Registered | 148 Jule Pond Dr, Southampton, NY 11968-3079 | 2018-08-24 |
| 1164952719 | Daniel Preiato | Dietitian, Registered | 41 Meeting House Ln, Southampton, NY 11968-4980 | 2017-06-15 |
| 1760015770 | Michael Ruhnau | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2020-02-18 |
| 1972136976 | Angelica Knuppel | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2020-02-18 |
| 1114312733 | Ruth Ann Jaffe | Dietitian, Registered | 501 Street Rd, Suite 100, Southampton, PA 18966-3796 | 2015-03-31 |
| 1508113036 | Martha Belknap | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2012-08-15 |
| 1073816591 | Claudia Jamile Santos | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2010-12-07 |
| 1689977134 | Maryanne Metzak | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2010-12-06 |
| 1780747188 | Sandra Noelle Alfano | Dietitian, Registered | 240 Meeting House Ln, Southampton, NY 11968-5009 | 2006-12-18 |
| Find all providers in SOUTHAMPTON | ||||
| City | SOUTHAMPTON |
| Zip Code | 18966 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.