Nicole Suzanne Kern, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.007411 Issued in IL

Practice address

750 42ND Avenue Dr
Moline, IL 61265-6893

Phone

(309) 757-1085

NPI assigned

Jun 20, 2018

Last updated

Jun 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hy-Vee Inc

  dba Hy-Vee Pharmacy (#1876)

  • Community/Retail Pharmacy
  • Wausau, WI
  • NPI 1396619839
  NPD (past)

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1063906329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 42ND AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656893",
            "telephone_number": "309-757-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 42ND AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656893",
            "telephone_number": "309-757-1085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 5th St",
            "address_purpose": "LOCATION",
            "city": "Silvis",
            "state": "IL",
            "postal_code": "612822903",
            "country_code": "US",
            "telephone_number": "309-792-1507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4218 Avenue Of The Cities",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612654544",
            "country_code": "US",
            "telephone_number": "309-762-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERN",
        "first_name": "NICOLE",
        "middle_name": "SUZANNE",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "091659",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.007411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan A. Kelley, DPT
• Tim Kelly
• Kennedy Chiropractic Center PC
• Timothy J Kennedy, DC
• Casey Patrick Kenney, D.M.D.
• Kevin D Smith D P M P C
• Sandra J Khoury, MD
• Kidney Care Quad Cities, LLC
• Killean Audiology & Hearing Aid CTRS
• Moses Kim, M.D.

• Registered Dietitian in Moline, IL
• Providers in Moline, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.