Individual provider Active NPI

Kathy Jean Barco

  • Registered Dietitian
  • Cleveland, OH
National Provider Identifier
1093833758
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L1139 Issued in OH
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 778-3076
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 L1139 OH Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

659 Canter Court
Avon Lake, OH 44012
Phone (440) 933-4402

Other names 1

  • Kathy Jean Thomas Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1139OHMDChiropractor
L1139OHMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093833758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 CANTER COURT",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "44012",
            "telephone_number": "440-933-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCO",
        "first_name": "KATHY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "L1139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "THOMAS",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.