Kimberly Jill Young, MS, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

D-718 Issued in ID

Practice address

8500 N. Atlas Rd.
Hayden, ID 83835

Phone

(208) 415-5100

Fax

(208) 415-5101

NPI assigned

Jul 25, 2018

Last updated

Jul 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1235616913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 N. ATLAS RD.",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-415-5100",
            "fax_number": "208-415-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 N. ATLAS RD.",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-415-5100",
            "fax_number": "208-415-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KIMBERLY",
        "middle_name": "JILL",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "1082713",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William a Forsyth (Northwoods Psychiatry LLC)
• Candace Williams, LMT
• Rebecca Markes Willson, MOT
• Dana Marie Wilson, CSFA
• Scott E Wilson, F.N.P
• Lana Rochelle Young, N.P.
• McKenna Briane Young, PT

• Registered Dietitian in Hayden, ID
• Providers in Hayden, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.