Individual provider Active NPI

Kathryn A. Redle, RD, CDE

  • Registered Dietitian
  • Sheridan, WY
National Provider Identifier
1164519872
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
459818
Practice address
1898 Fort Rd
VA Medical Center (120)
Sheridan, WY 82801-8320
Phone
(307) 672-3473
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 459818 Primary

Addresses

Primary practice location

1898 Fort Rd
VA Medical Center (120)
Sheridan, WY 82801-8320

Mailing address

115 Red Fox Dr
Sheridan, WY 82801-8647
Phone (307) 674-4642

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164519872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 RED FOX DR",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018647",
            "telephone_number": "307-674-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 FORT RD",
            "address_2": "VA MEDICAL CENTER (120)",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828018320",
            "telephone_number": "307-672-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDLE",
        "first_name": "KATHRYN",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "459818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.