Kori Fawn Abbott, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI 60023537 Issued in WA

Practice address

655 Al Dorsey LN NW
Bainbridge Island, WA 98110-2729

Phone

(206) 201-3642

NPI assigned

Oct 23, 2008

Last updated

Oct 23, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kori Fawn Clot Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1174776991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 AL DORSEY LN NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102729",
            "telephone_number": "206-201-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 AL DORSEY LN NW",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102729",
            "telephone_number": "206-201-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "KORI",
        "middle_name": "FAWN",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI 60023537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORI",
            "last_name": "CLOT",
            "middle_name": "FAWN",
            "prefix": "MS.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.