Individual provider Active NPI

Karen Petermeyer, RDN, CD

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1003369174
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI 60412193 Issued in WA
Practice address
11535 39TH Ave NE
Seattle, WA 98125-5717
Phone
(503) 784-1170
NPI assigned
Jul 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI 60412193 WA Primary

Addresses

Primary practice location

11535 39TH Ave NE
Seattle, WA 98125-5717

Mailing address

11535 39TH Ave NE
Seattle, WA 98125-5717
Phone (503) 784-1170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI 60412193WAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1003369174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 39TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255717",
            "telephone_number": "503-784-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 39TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255717",
            "telephone_number": "503-784-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMEYER",
        "first_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI 60412193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.