Active NPI
Katherine M Carlson, RD
- Renal Nutrition Registered Dietitian
- Brooklyn Center, MN
National Provider Identifier
1023253069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 2780
- Practice address
- 6200 Shingle Creek Pkwy
Ste 300
Brooklyn Center, MN 55430-2128 - Phone
- (763) 746-9010
- Fax
- (763) 746-9022
- NPI assigned
- Dec 4, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 2780 | MN | Primary |
Addresses
Primary practice location
6200 Shingle Creek Pkwy
Ste 300
Brooklyn Center, MN 55430-2128
Mailing address
5117 Drew Ave S
Minneapolis, MN 55410-2028
Phone (763) 746-9010
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2780 | MN | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228348800000",
"number": "1023253069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5117 DREW AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554102028",
"telephone_number": "763-746-9010",
"fax_number": "763-746-9022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 SHINGLE CREEK PKWY",
"address_2": "STE 300",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554302128",
"telephone_number": "763-746-9010",
"fax_number": "763-746-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "KATHERINE",
"middle_name": "M",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-04",
"last_updated": "2008-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "MN",
"license": "2780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.