CHAD HETHERWICK MS RDN NPI 1104023969

NPI Information

  • NPI: 1104023969
  • Provider Name: CHAD HETHERWICK, MS, RDN
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Individual
  • Address: 8508 N PRAIRIE VW
    PRESCOTT VALLEY, AZ
    ZIP 86315
  • Phone: (928) 772-8652

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NPI Details

Chad Hetherwick, MS, RDN is a dietitian registered in Prescott Valley, AZ with 22 years of experience. The provider is 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. Chad Hetherwick, MS, RDN NPI is 1104023969. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8508 N PRAIRIE VW
PRESCOTT VALLEY, AZ
ZIP 86315-089
Phone: (928) 772-8652
Fax: (928) 772-8078

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Therapy procedure for nutrition management, each 15 minutes (HCPCS:97802)

The enumeration date for this NPI number is 6/27/2007 and was last updated on 11/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, Registered960912Yes
2133VN1004XDietitian, RegisteredNutrition, PediatricNo
3133VN1005XDietitian, RegisteredNutrition, RenalNo
4133VN1006XDietitian, RegisteredNutrition, MetabolicNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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