Kimberly Cook Boehm, RD
Individual provider Active NPI Registered Dietitian · Baldwin, IL
NPI 1023970829 · NPPES record last updated Dec 1, 2025
Key facts
- NPI
- 1023970829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164.008217 (IL)
- Practice address
- 8941 Baldwin Rd
Baldwin, IL 62217-1607 - Phone
- (618) 606-0493
- NPI assigned
- Dec 1, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.008217 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group of New Jersey, P.C. | Past | Accepting new patients | |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.008217 | IL | Yes |
Addresses
Primary practice location
8941 Baldwin Rd
Baldwin, IL 62217-1607
Mailing address
8941 Baldwin Rd
Baldwin, IL 62217-1607
Phone (618) 606-0493
Other providers in Baldwin, IL
All providers in Baldwin, IL · Registered Dietitian in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.