Individual provider Active NPI

Kimberly Spirek

  • Registered Dietitian
  • Champaign, IL
National Provider Identifier
1073127395
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86116083 Issued in IL
Practice address
310 E Springfield Ave Apt 1208
Champaign, IL 61820-4945
Phone
(847) 975-4464
NPI assigned
Sep 3, 2020
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86116083 IL Primary

Addresses

Primary practice location

310 E Springfield Ave Apt 1208
Champaign, IL 61820-4945

Mailing address

310 E Springfield Ave Apt 1208
Champaign, IL 61820-4945
Phone (847) 975-4464

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

LicenseStateTypeSpecialty
86116083ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1073127395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E SPRINGFIELD AVE APT 1208",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204945",
            "telephone_number": "847-975-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E SPRINGFIELD AVE APT 1208",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204945",
            "telephone_number": "847-975-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIREK",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86116083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.