Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053974337 Individual Practitioner Female Practitioner

Kellie Faughander Wall , RD, CNSC, CDN

Dietitian, Registered • Syracuse, NY

Professional Overview & Biography Verified Profile Summary

Kellie Wall, RD, CNSC, CDN is a registered healthcare professional specializing in Dietitian, Registered in Syracuse, NY. Practice services are available at 750 E ADAMS ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

750 E Adams St

Syracuse, NY 132102306

Telephone 2404901346
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Syracuse, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.0 Yrs
State Avg: 17.7 Yrs
Regional Practice Density
93 Specialists

Practicing in Syracuse, NY (4786 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-02-26
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License NY 1058216

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. David Kanter , MD

Physical Medicine & Rehabilitation

NPI 1003001371

Doctor of Medicine (M.D.)

Dr. Brennan Ellis , MD

Emergency Medicine

NPI 1003019514

Doctor of Medicine (M.D.)

NPI 1003343237

Doctor of Osteopathic Medicine (D.O.)

Dr. Bethany Hawke , MD

Emergency Medicine

NPI 1003348582

Doctor of Medicine (M.D.)

Dr. Billal Mohmand , MD

Student in an Organized Health Care Education/Training Program

NPI 1003468075

Doctor of Medicine (M.D.)

Dr. Dayana Nasr , MD

Student in an Organized Health Care Education/Training Program

NPI 1003486358

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
👤
Provider Name / Credentials Updated February 26, 2024

Recorded as KELLIE WALL, RD, CNSC, CDN

NPI Profile Active April 22, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location April 22, 2019

Registered at 750 E ADAMS ST, SYRACUSE, NY 132102306 (Tel: 2404901346)

📍
Updated Business Mailing Address April 22, 2019

Registered at 9105 ASHLEY LANDING DRIVE, CLAY, NY 13041 (Tel: 2404901346)

👤
Provider Name / Credentials Updated April 22, 2019

Recorded as KELLIE WALL, RD, CNSC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2019

Dietitian, Registered (License #1058216 in NY)

🟢
Initial NPI Registration & Enumeration April 22, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053974337
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 22, 2019
Last Update: February 26, 2024
Sole Proprietor: No

Mailing Address

9105 Ashley Landing Drive

Clay, NY 13041

Phone: 2404901346

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.