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CHAD HETHERWICK MS, RDN
NPI 1104023969
Dietitian, Registered in Prescott Valley, AZ

Active since June 27, 2007Accepts Medicare Assignment
8508 N PRAIRIE VW, PRESCOTT VALLEY, AZ 86315(928) 772-8652(928) 772-8078 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 3, 2020, Mar 15, 2019 (2 updates tracked since 2019).

About Chad Hetherwick Ms, Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAD HETHERWICK MS, RDN (NPI 1104023969) is an individual dietitian, registered in Prescott Valley, Arizona, licensed in (960912) and active in the NPI registry since June 2007. He is a graduate of Other (2004).

NPPES Registry Identity

NPI1104023969
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameCHAD HETHERWICKCredential: MS, RDN
Location Address8508 N PRAIRIE VWPrescott Valley, AZ 86315-9089
Mailing AddressPo Box 10214Prescott, AZ 86304-0214 · (928) 772-8652 · Fax (928) 772-8078
Phone(928) 772-8652
Fax(928) 772-8078
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJune 27, 2007
Last NPPES UpdateNovember 3, 20202 updates tracked since enumeration
NPPES CertifiedNovember 3, 2020
✔ NPI 1104023969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed · 960912
Definition
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.
Also ListedDietitian, Registered · Nutrition, PediatricTaxonomy 133VN1004X
Also ListedDietitian, Registered · Nutrition, RenalTaxonomy 133VN1005X
Also ListedDietitian, Registered · Nutrition, MetabolicTaxonomy 133VN1006X
8508 N PRAIRIE VW, Prescott Valley, AZ 86315
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chad Hetherwick Ms, Rdn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012937196
PECOS Enrollment IDI20051205000283

Medicare Billing Reassignments

2

Medicare enrollment records show Chad Hetherwick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prairie View Creations LLC
Same address
Dietitian, Registered
8508 N PRAIRIE VW
Prescott Valley, AZ 86315
  • Reassigned Medicare billing, Arizona enrollment
  • 2 clinicians in this Medicare group
NPI 1063979961 (928) 772-8652
Yavapai Community Hospital Association
5.4 mi
General Acute Care Hospital
7700 E FLORENTINE RD
Prescott Valley, AZ 86314
  • Reassigned Medicare billing, Arizona enrollment
  • 83 clinicians in this Medicare group
NPI 1871534487 (928) 445-2700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure for nutrition management, each 15 minutes 97802
This is a 15-minute session focused on managing your nutrition. A professional will assess your dietary habits and provide personalized advice to improve your health. It can help manage weight, control chronic diseases, and promote overall wellbeing.
135 services27 patients
Therapy procedure reassessment for nutrition management, each 15 minutes 97803
This is a process where a healthcare professional reviews your nutritional needs every 15 minutes. It's part of managing your diet to ensure optimal health. The review may involve adjusting your meal plans, evaluating your body's response to certain foods, and monitoring your overall nutrition status.
100 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86315 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.44 – $168.60
Typical copayment $0.00 (range $13.86 – $42.15)
Most-billed visit code NA
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRAIRIE VIEW CREATIONS LLC
Dietitian, Registered
8508 N PRAIRIE VW
PRESCOTT VALLEY, AZ 86315
Yavapai County (928) 772-8652
KRISTIN LEWIS R.D.
Dietitian, Registered (Nutrition, Renal)
8508 N PRAIRIE VW
PRESCOTT VALLEY, AZ 86315
Yavapai County (928) 772-8652

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chad Hetherwick's NPI number?

The NPI number for Chad Hetherwick is 1104023969. It was assigned to this individual provider in the NPPES registry on June 27, 2007.

Where is Chad Hetherwick located?

Chad Hetherwick practices at 8508 N Prairie Vw, Prescott Valley, AZ 86315. The listed phone number is (928) 772-8652.

What is Chad Hetherwick's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Chad Hetherwick enrolled in Medicare?

Yes. Chad Hetherwick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Chad Hetherwick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chad Hetherwick reassigns Medicare benefits to 2 organizations: Prairie View Creations LLC (Prescott Valley, AZ) and Yavapai Community Hospital Association (Prescott Valley, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chad Hetherwick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Chad Hetherwick accept?

Health plans from Blue Cross Blue Shield of Arizona and Imperial Insurance Companies, Inc. list Chad Hetherwick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Chad Hetherwick was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.