Active NPI
Kaitlin Poillon, RDN, LDN
- Registered Dietitian
- Philadelphia, PA
National Provider Identifier
1013689405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN006536
- Practice address
- 1601 Cherry St FL 2
Philadelphia, PA 19102-1306 - Phone
- (215) 553-7012
- NPI assigned
- Oct 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN006536 | PA | Primary |
Addresses
Primary practice location
1601 Cherry St FL 2
Philadelphia, PA 19102-1306
Mailing address
1136 N American St Unit 106
Philadelphia, PA 19123-1677
Phone (717) 715-3943
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN006536 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Networks
- TX HMO
- TX HMO D-SNP
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1013689405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1136 N AMERICAN ST UNIT 106",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191231677",
"telephone_number": "717-715-3943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 CHERRY ST FL 2",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021306",
"telephone_number": "215-553-7012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POILLON",
"first_name": "KAITLIN",
"credential": "RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-04",
"last_updated": "2021-10-04",
"certification_date": "2021-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN006536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.