Sandy Kipp RDN LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

SANDY KIPP RDN LLC

Practice address

1105 2ND St. S.
Nampa, ID 83651

Phone

(208) 250-0836

Fax

(888) 972-6280

NPI assigned

Jul 20, 2020

Organization subpart

No

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

Authorized official

Name

Sandra Kipp, RDNNPI 1295145654

Title

Owner/Dietitian

Phone

(208) 250-0836

Specialties & licenses 1

Addresses

Other names 1

• 'In care of' NOURISH YOUR LIFE Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Kipp, RDN

  • Registered Dietitian
  • Nampa, ID
  • NPI 1295145654

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1164030755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 W MOUNTAIN ASH LOOP",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862681",
            "telephone_number": "208-250-0836",
            "fax_number": "888-972-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 2ND ST. S.",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83651",
            "telephone_number": "208-250-0836",
            "fax_number": "888-972-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 W Mountain Ash Loop",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836862681",
            "country_code": "US",
            "telephone_number": "208-250-0836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDY KIPP RDN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "KIPP",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "208-250-0836",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "'In care of' NOURISH YOUR LIFE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ricardo Sanchez, RDH
• Tony A Sandburg, PHARMD
• Laura L Sander, LPC
• Rosalie Gwendolyn Sanders, LPC
• Roxana M Sandor
• Evan David Sanford, DPT
• Sanoura Haven LLC
• Stephanie Saravschi
• Paul Sarkaria, DO
• Chris Satchwell, D.M.D.

• Registered Dietitian in Nampa, ID
• Providers in Nampa, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.