Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Chad Hetherwick, MS, RDN

Individual provider Pediatric Nutrition Registered Dietitian · NPI 1104023969

Chad Hetherwick, MS, RDN is a Registered Dietitian OR Nutrition Professional in Prescott Valley, Arizona. Qualified in 2004, 22 years ago. Practices with Prairie View Creations LLC, a 2-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
22
In the registry since
2007
Specialties on file
4
What do these letters mean?
MS — Master of Science
A graduate science degree.
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

See every abbreviation used in this directory →

Practice location Address checks out

8508 N Prairie Vw
Prescott Valley, AZ 86315-9089
Phone: (928) 772-8652
Fax: (928) 772-8078
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 960912
Pediatric Nutrition Registered Dietitian Taxonomy 133VN1004X
Renal Nutrition Registered Dietitian Taxonomy 133VN1005X
Metabolic Nutrition Registered Dietitian Taxonomy 133VN1006X

Record details

NPI number1104023969
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , RDN
Sole proprietorNo
NPI enumeratedJune 27, 2007
Last updated in NPPESNovember 3, 2020
Certification dateNovember 3, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Prairie View Creations Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services