Organization Active NPI

Kidney Focused Nutrition LLC

  • Renal Nutrition Registered Dietitian
  • Muskego, WI
National Provider Identifier
1144096199
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
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

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Laura Fons, RDN CSRNPI 1861047813
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)CodeLicenseStatePrimary
Renal Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 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

Enrollment IDStateProvider typePAC IDDetails
O20240118003590 WI Part B Supplier - Clinic/Group Practice 8820440472 Receives reassigned benefits from 1 practitioner
Practice locations: Muskego, WI

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.