Active NPI
Katelynn Marie Hackl, RDN
- Registered Dietitian
- St Thomas, VI
National Provider Identifier
1073215299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86174855
- Practice address
- 5316 Yacht Haven Grande
Building N Suite 101
St Thomas, VI 00802 - Phone
- (340) 244-4470
- NPI assigned
- Mar 21, 2023
- Last updated
- Mar 21, 2023
- 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 | 86174855 | WI | Primary |
Addresses
Primary practice location
5316 Yacht Haven Grande
Building N Suite 101
St Thomas, VI 00802
Mailing address
8170 Crown Bay Marina
PMB 159
St Thomas, VI 00802
Phone (920) 883-0559
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86174855 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679356800000",
"number": "1073215299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 CROWN BAY MARINA",
"address_2": "PMB 159",
"city": "ST THOMAS",
"state": "VI",
"postal_code": "00802",
"telephone_number": "920-883-0559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5316 YACHT HAVEN GRANDE",
"address_2": "BUILDING N SUITE 101",
"city": "ST THOMAS",
"state": "VI",
"postal_code": "00802",
"telephone_number": "340-244-4470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKL",
"first_name": "KATELYNN",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-21",
"last_updated": "2023-03-21",
"certification_date": "2023-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "86174855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Thomas, VI
- Sonia A. Griffith, D.D.S
- Angela Grimaldi, PA
- Jessi Grostefon, PA-C
- Jeffrey Guller, MD
- Imnett Habtes, M.D.
- Gayann Irena Hall, M.D.
- Lekisha Ann Hamilton, D.C.
- Handicap Safety Group LLC (Trinity Transport)
- Handicap Safety Group LLC (Trinity Transport LLC)
- Handicap Safety Group LLC (Trinity Transport LLC)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.