Chad Hetherwick, MS, RDN
NPI 1104023969ActiveIndividual· Dietitian, Registered· Prescott Valley, AZ
Dietitian, Registered (MS, RDN) with Prairie View Creations LLC, practicing in Prescott Valley, Arizona. Medicare paid $9,122 for services to 31 patients in 2024.
Overview
| NPI | 1104023969 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, RDN |
| Sole proprietor | No |
| NPI issued | Jun 27, 2007 |
| Last updated in NPPES | Nov 3, 2020 |
| Certified by provider | Nov 3, 2020 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (AZ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 31 |
|---|---|
| Services billed | 332 across 3 procedure codes |
| Paid by Medicare | $9,122 |
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
| Telehealth | Offers telehealth |
Medical group
- Prairie View Creations LLCPrescott Valley, AZ · 2 clinicians
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