Individual provider Active NPI

Kaycie Lindeman, RDN, LD

  • Registered Dietitian
  • St Anthony, MN
National Provider Identifier
1215325402
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3479 Issued in MN
Practice address
2855 Anthony LN S Ste 125
St Anthony, MN 55418-3265
Phone
(612) 360-6225
Fax
(888) 509-6038
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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 3479 MN Primary

Addresses

Primary practice location

2855 Anthony LN S Ste 125
St Anthony, MN 55418-3265

Mailing address

2519 Pierce St NE
Minneapolis, MN 55418-3839
Phone (612) 360-6225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150220000620 MN Practitioner - Registered Dietitian Or Nutrition Professional 8820313539 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3479MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Kaycie Rose Nutrition LLC Dietitian, Registered CurrentSince Aug 6, 2023 Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Jan 7, 2019 Accepting new patients
Fairview Health Services CurrentSince Dec 22, 2014 Accepting new patients
Fairview Health Services Dietitian, Registered Current Accepting new patients
Fairview Clinics CurrentSince Dec 22, 2014 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

3001 Broadway St NE
Ste 120
Minneapolis, MN 55413

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2855 Anthony Ln S
Ste 125
St Anthony, MN 55418
Phone (612) 360-6225

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1215325402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 PIERCE ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183839",
            "telephone_number": "612-360-6225",
            "fax_number": "888-509-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 ANTHONY LN S STE 125",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554183265",
            "telephone_number": "612-360-6225",
            "fax_number": "888-509-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEMAN",
        "first_name": "KAYCIE",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Anthony, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.