Individual provider Active NPI

Laurie A. Kutrich, CD, RD

  • Registered Dietitian
  • Wenatchee, WA
National Provider Identifier
1164509196
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00001860 Issued in WA
Practice address
1201 S Miller St
Wenatchee, WA 98801-3201
Phone
(509) 662-1511
Fax
(509) 665-6261
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00001860 WA Primary

Addresses

Primary practice location

1201 S Miller St
Wenatchee, WA 98801-3201

Mailing address

1201 S. Miller
Central Washington Hospital
Wenatchee, WA 98801-3201
Phone (509) 662-1511

Other identifiers 2

IdentifierTypeStateIssuer
1164509196MedicaidWA
P01522105OtherWARR PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/
Direct Messaging Address lkutrich12140@edirect.chehr.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000381 WA Practitioner - Registered Dietitian Or Nutrition Professional 1759483662 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI00001860WAMDRegistered Dietitian

Interoperability endpoints

  • Direct secure messaging: lkutrich12140@edirect.chehr.org

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1164509196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S. MILLER",
            "address_2": "CENTRAL WASHINGTON HOSPITAL",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-662-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-662-1511",
            "fax_number": "509-665-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTRICH",
        "first_name": "LAURIE",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "CD, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164509196",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "P01522105",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkutrich12140@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "1201 S Miller St",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988013201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.