Active NPI
Lauren Kunken, RDN
- Registered Dietitian
- Commerce Township, MI
National Provider Identifier
1124853676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1856
- Practice address
- 4343 Kelsey Farm Dr
Commerce Township, MI 48390-1330 - Phone
- (402) 305-2222
- NPI assigned
- Sep 4, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 128320 | IA | |
| Registered Dietitian | 133V00000X | 1856 | NE | Primary |
Addresses
Primary practice location
4343 Kelsey Farm Dr
Commerce Township, MI 48390-1330
Mailing address
4343 Kelsey Farm Dr
Commerce Township, MI 48390-1330
Phone (402) 305-2222
Other practice location 1
11414 W Center Rd Ste 321
Omaha, NE 68144-4420
Phone (402) 305-2222
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 |
|---|---|---|---|
| 128320 | IA | MD | Registered Dietitian |
| 1856 | NE | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Positive Nutrition of Omaha LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1124853676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4343 KELSEY FARM DR",
"city": "COMMERCE TOWNSHIP",
"state": "MI",
"postal_code": "483901330",
"telephone_number": "402-305-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4343 KELSEY FARM DR",
"city": "COMMERCE TOWNSHIP",
"state": "MI",
"postal_code": "483901330",
"telephone_number": "402-305-2222"
}
],
"practiceLocations": [
{
"address_1": "11414 W Center Rd Ste 321",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681444420",
"country_code": "US",
"telephone_number": "402-305-2222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUNKEN",
"first_name": "LAUREN",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-04",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "128320",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "1856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.