Active NPI
Kyli Gough, RDN, LD
- Registered Dietitian
- Twin Falls, ID
National Provider Identifier
1154783199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-781
- Practice address
- 496 Shoup Ave W Ste a
Twin Falls, ID 83301-5043 - Phone
- (208) 814-9182
- NPI assigned
- Mar 28, 2016
- 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 | D-781 | ID | Primary |
Addresses
Primary practice location
496 Shoup Ave W Ste a
Twin Falls, ID 83301-5043
Mailing address
PO Box 599
Shoshone, ID 83352-0599
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 |
|---|---|---|---|
| D-781 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459123200000",
"number": "1154783199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 599",
"city": "SHOSHONE",
"state": "ID",
"postal_code": "833520599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 SHOUP AVE W STE A",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015043",
"telephone_number": "208-814-9182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUGH",
"first_name": "KYLI",
"credential": "RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-28",
"last_updated": "2016-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D-781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.