Active NPI
Kidney Focused Nutrition LLC
- Renal Nutrition Registered Dietitian
- Muskego, WI
National Provider Identifier
1144096199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- Legal business name
- KIDNEY FOCUSED NUTRITION LLC
- Practice address
- S76W12816 Cambridge CT E
Muskego, WI 53150-4004 - Phone
- (414) 412-2812
- NPI assigned
- Nov 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura Fons, RDN CSR
- Title
- Member
- Phone
- (414) 412-2812
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | Primary |
Addresses
Primary practice location
S76W12816 Cambridge CT E
Muskego, WI 53150-4004
Mailing address
S76W12816 Cambridge CT E
Muskego, WI 53150-4004
Phone (414) 412-2812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Renal Nutrition Registered Dietitian
- Muskego, WI
- NPI 1861047813
Nutrition, Renal
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701302400000",
"number": "1144096199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "S76W12816 CAMBRIDGE CT E",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531504004",
"telephone_number": "414-412-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S76W12816 CAMBRIDGE CT E",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531504004",
"telephone_number": "414-412-2812"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIDNEY FOCUSED NUTRITION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-30",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A",
"authorized_official_last_name": "FONS",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "414-412-2812",
"authorized_official_credential": "RDN CSR"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muskego, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.