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Deactivated NPI 1235522574 Deactivated / Inactive NPI Female Practitioner

Kimberly Emmick , RDN, LDN

Dietitian, Registered • Mount Vernon, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kimberly Emmick has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 11, 2015
NPI Deactivation Date November 14, 2023
Total Practice Duration ~8 Years of Practice (2015 – 2023)

Professional Overview & Biography Verified Profile Summary

Kimberly Emmick, RDN, LDN was a registered Dietitian, Registered practicing in Mount Vernon, WA. Throughout an active medical career spanning 8 years, Kimberly Emmick provided care at the practice location at 14573 BEAVER MARSH RD until profile deactivation on 2023-11-14.

Practice Location & Contact Primary Location

Practice Address

14573 Beaver Marsh Rd

Mount Vernon, WA 982739774

Telephone 5642607466

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Mount Vernon, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
12 Specialists

Practicing in Mount Vernon, WA (2154 Statewide)

Telehealth Adoption Rate
8.3% 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: 2026-01-30
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License WA DI00001781

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.

Career & Practice History Timeline

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

14 Historical Events
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Updated Practice Location January 30, 2026

Registered at 14573 BEAVER MARSH RD, MOUNT VERNON, WA 982739774 (Tel: 5642607466)

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Updated Business Mailing Address January 30, 2026

Registered at 14573 BEAVER MARSH RD, MOUNT VERNON, WA 982739774 (Tel: 5642607466)

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Provider Name / Credentials Updated January 30, 2026

Recorded as KIMBERLY EMMICK, RDN, LDN

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Updated Practice Location December 10, 2025

Registered at 129 EDEN VALLEY RD, ROSBURG, WA 986439637 (Tel: 3479010574)

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Updated Business Mailing Address December 10, 2025

Registered at 129 EDEN VALLEY RD, ROSBURG, WA 986439637 (Tel: 3479010574)

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Provider Name / Credentials Updated December 10, 2025

Recorded as KIMBERLY EMMICK

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2025

Dietitian, Registered (License #DI00001781 in WA)

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NPI Profile Deactivated November 14, 2023

Record deactivated on November 14, 2023

NPI Profile Active May 23, 2016

NPI status registered as active in NPPES database

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Updated Practice Location May 23, 2016

Registered at 129 EDEN VALLEY RD, ROSBURG, WA 986439637 (Tel: 3479010574)

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Updated Business Mailing Address May 23, 2016

Registered at 129 EDEN VALLEY RD, ROSBURG, WA 986439637 (Tel: 3479010574)

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Provider Name / Credentials Updated May 23, 2016

Recorded as KIMBERLY EMMICK

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2016

Dietitian, Registered (License #DI00001781 in WA)

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Initial NPI Registration & Enumeration March 11, 2015

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: 1235522574
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 11, 2015
Last Update: January 30, 2026
Deactivation Date: November 14, 2023
Sole Proprietor: Yes

Mailing Address

14573 Beaver Marsh Rd

Mount Vernon, WA 982739774

Phone: 5642607466

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

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