NPIMap

Individual provider Active NPI

Kimberly M Otter, RD LDN

  • Registered Dietitian
  • Quincy, IL
National Provider Identifier
1245232909
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
935 Jersey St
Quincy, IL 62301-4030
Phone
(217) 228-2413
Fax
(217) 228-2416
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2004029302 MO
Registered Dietitian 133V00000X IL Primary

Addresses

Primary practice location

935 Jersey St
Quincy, IL 62301-4030

Mailing address

935 Jersey St
Quincy, IL 62301-4030
Phone (217) 228-2413

Other identifiers 3

IdentifierTypeStateIssuer
075113OtherILQUINCY HEALTH CARE MGMT.
000009329891OtherILPRIVATE HEALTHCARE SYSTEM
00132009OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Miss Kimberly M Swedell I 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
164004052ILMDRegistered Dietitian
2004029302MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Solutions of Quincy, Inc. Dietitian, Registered Past Accepting new patients
Cloud Health Medical Group of New Jersey, P.C. Past Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Everfit Inc Dietitian, Registered Past Accepting new patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245232909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 JERSEY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014030",
            "telephone_number": "217-228-2413",
            "fax_number": "217-228-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 JERSEY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014030",
            "telephone_number": "217-228-2413",
            "fax_number": "217-228-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTER",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RD LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2004029302",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUINCY HEALTH CARE MGMT.",
            "identifier": "075113",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "000009329891",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00132009",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SWEDELL",
            "middle_name": "M",
            "prefix": "MISS",
            "suffix": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.