Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154194876 Individual Practitioner Female Practitioner

Kaci Blackshear

Dietitian, Registered • Winnie, TX

Professional Overview & Biography Verified Profile Summary

Kaci Blackshear is a registered healthcare professional specializing in Dietitian, Registered in Winnie, TX. Practice services are available at 538 BROADWAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

538 Broadway

Winnie, TX 776657600

Telephone 4092966000
Fax 4092966372
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Winnie, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.6 Yrs
Regional Practice Density
2 Specialists

Practicing in Winnie, TX (5148 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: 2023-11-03
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License TX DT89065

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.

Secondary Practice Locations

85 Ih 10 N Ste 208

Beaumont, TX 777072539

Phone: 4098421112

515 S Archie St

Vidor, TX 776624868

Phone: 4097692295

2400 Highway 365 Ste 208

Nederland, TX 776276250

Phone: 4097308054

85 Ih 10 N Ste 112

Beaumont, TX 777072560

Phone: 4092395139

403 S Magnolia St

Woodville, TX 759795238

Phone: 4092832888

2400 Highway 365 Ste 112

Nederland, TX 776276268

Phone: 4097247900

Practice Associates & Co-Workers

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

11 Associated Practitioners
Dr. Robert Mena , MD

Family Medicine

NPI 1073657482

Doctor of Medicine (M.D.)

Margaret Campbell

Counselor - Professional

NPI 1194424564
Martha Davis , PA

Physician Assistant

NPI 1376618736

Physician Assistant

Hilari Berklund , PA-C

Physician Assistant

NPI 1376650705

Physician Assistant (Certified)

NPI 1417804881

Licensed Master Social Worker

NPI 1427088673

Advanced Practice Nurse, Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active November 03, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location November 03, 2023

Registered at 538 BROADWAY, WINNIE, TX 776657600 (Tel: 4092966000)

📍
Updated Business Mailing Address November 03, 2023

Registered at 538 BROADWAY, WINNIE, TX 776657600 (Tel: 4092966000)

👤
Provider Name / Credentials Updated November 03, 2023

Recorded as KACI BLACKSHEAR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 03, 2023

Dietitian, Registered (License #DT89065 in TX)

🟢
Initial NPI Registration & Enumeration November 03, 2023

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: 1154194876
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 03, 2023
Last Update: November 03, 2023
Sole Proprietor: No

Mailing Address

538 Broadway

Winnie, TX 776657600

Phone: 4092966000

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.