Lynn M Kitslaar, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1399-29 Issued in WI

Practice address

1630 Commanche Ave
Green Bay, WI 54313-5753

Phone

(920) 430-4700

Fax

(920) 430-4747

NPI assigned

Dec 7, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • De Pere, WI
  • NPI 1053374314
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1255316717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-430-4700",
            "fax_number": "920-430-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2714 Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136715",
            "country_code": "US",
            "telephone_number": "920-430-4760",
            "fax_number": "920-430-4774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 S Webster Ave Ste 501",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013528",
            "country_code": "US",
            "telephone_number": "920-433-6050",
            "fax_number": "920-433-6049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITSLAAR",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "WI",
            "license": "1399-29",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1399-29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS",
            "identifier": "20110340",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "850912",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Tary Kirsch, M.S., LPC
• John P Kiser, MD
• Kismet Advocacy LLC
• Thomas Kissner
• Sarah Kitchen
• Deborah Marie Kleiman, RN
• Molly May Kleiman, M.D.
• Abigail Marie Klein, APNP
• Angela A Klein, APNP
• Jason Paul Klein, MD

• Registered Dietitian in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.