Active NPI
Madison Marie Keller, MS, RDN
- Registered Dietitian
- Kuna, ID
National Provider Identifier
1023693405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 974 S Rangipo Ave
Kuna, ID 83634-5569 - Phone
- (775) 309-7158
- NPI assigned
- Mar 16, 2021
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
974 S Rangipo Ave
Kuna, ID 83634-5569
Mailing address
974 S Rangipo Ave
Kuna, ID 83634-5569
Phone (775) 309-7158
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1023693405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "974 S RANGIPO AVE",
"city": "KUNA",
"state": "ID",
"postal_code": "836345569",
"telephone_number": "775-309-7158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "974 S RANGIPO AVE",
"city": "KUNA",
"state": "ID",
"postal_code": "836345569",
"telephone_number": "775-309-7158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "MADISON",
"middle_name": "MARIE",
"credential": "MS, RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-16",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kuna, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.