Individual provider Active NPI

Kiran Campbell, RDN

  • Registered Dietitian
  • Saint Charles, MI
National Provider Identifier
1174380273
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
994236 Issued in MI
Practice address
11575 Turner Rd
Saint Charles, MI 48655-9611
Phone
(989) 450-5228
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 994236 MI Primary

Addresses

Primary practice location

11575 Turner Rd
Saint Charles, MI 48655-9611

Mailing address

11575 Turner Rd
Saint Charles, MI 48655-9611
Phone (989) 450-5228

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

LicenseStateTypeSpecialty
994236MIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1174380273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11575 TURNER RD",
            "city": "SAINT CHARLES",
            "state": "MI",
            "postal_code": "486559611",
            "telephone_number": "989-450-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11575 TURNER RD",
            "city": "SAINT CHARLES",
            "state": "MI",
            "postal_code": "486559611",
            "telephone_number": "989-450-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KIRAN",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "994236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.