Individual provider Active NPI

Margaret A Koenig, RD, LD, CDE

  • Registered Dietitian
  • Canton, OH
National Provider Identifier
1174536452
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD702 Issued in OH
Practice address
4565 Dressler Rd NW
Canton, OH 44718-2549
Phone
(330) 493-0013
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 LD702 OH Primary

Addresses

Primary practice location

4565 Dressler Rd NW
Canton, OH 44718-2549

Mailing address

6190 Deer Holw
Clinton, OH 44216-8674
Phone (330) 472-0999

Other practice location 1

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 489-1099

Other names 1

  • Margaret A Boldt Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD702OHMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1174536452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 DEER HOLW",
            "city": "CLINTON",
            "state": "OH",
            "postal_code": "442168674",
            "telephone_number": "330-472-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182549",
            "telephone_number": "330-493-0013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Mercy Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447082614",
            "country_code": "US",
            "telephone_number": "330-489-1099",
            "fax_number": "330-489-1346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "MARGARET",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "BOLDT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.