Active NPI
Corinna Rachel Kudwa, MS, RDN
- Registered Dietitian
- Mt Pleasant, MI
National Provider Identifier
1215432471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 329500852
- Practice address
- 113 W Broadway St Ste 200
Mt Pleasant, MI 48858-2575 - Phone
- (989) 400-1478
- NPI assigned
- Mar 28, 2018
- Last updated
- Mar 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 329500852 | MI | Primary |
Addresses
Primary practice location
113 W Broadway St Ste 200
Mt Pleasant, MI 48858-2575
Mailing address
150 Fenner Rd
Ovid, MI 48866-9546
Phone (989) 413-8031
Other practice location 1
410 W Cherry St
MT Pleasant, MI 48858-2473
Phone (989) 413-8031
Other practice location 2
206 W Wackerly St
Midland, MI 48640-2790
Phone (989) 486-8484
Other practice location 3
1001 Fairfield Dr
MT Pleasant, MI 48858-4317
Phone (989) 954-4673
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 329500852 | MI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitch PC | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Allara Medical Group PA | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Gynecology Physician
- New York, NY
- NPI 1700450558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522368000000",
"number": "1215432471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 FENNER RD",
"city": "OVID",
"state": "MI",
"postal_code": "488669546",
"telephone_number": "989-413-8031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 W BROADWAY ST STE 200",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488582575",
"telephone_number": "989-400-1478"
}
],
"practiceLocations": [
{
"address_1": "410 W Cherry St",
"address_purpose": "LOCATION",
"city": "MT Pleasant",
"state": "MI",
"postal_code": "488582473",
"country_code": "US",
"telephone_number": "989-413-8031",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "206 W Wackerly St",
"address_purpose": "LOCATION",
"city": "Midland",
"state": "MI",
"postal_code": "486402790",
"country_code": "US",
"telephone_number": "989-486-8484",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1001 Fairfield Dr",
"address_purpose": "LOCATION",
"city": "MT Pleasant",
"state": "MI",
"postal_code": "488584317",
"country_code": "US",
"telephone_number": "989-954-4673",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUDWA",
"first_name": "CORINNA",
"middle_name": "RACHEL",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2018-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "329500852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.