Katie Nicole Klug, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1155 Issued in ND

Practice address

2615 Fairway St
Dickinson, ND 58601-2590

Phone

(701) 456-6000

NPI assigned

Oct 13, 2020

Last updated

May 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Katie Nicole Pavlicek Former name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.63 of 100Reported as group

Quality

89.39

Promoting interoperability

100

Improvement activities

40

Cost

76.04

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Bismarck

  dba Family Wellness

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1255939146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "701-456-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012590",
            "telephone_number": "701-456-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Fairway St",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "586012639",
            "country_code": "US",
            "telephone_number": "701-456-4976",
            "fax_number": "701-456-4866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUG",
        "first_name": "KATIE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "PAVLICEK",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catherine King
• Rachel Renee Kisse, PA-C
• Whitney R Kitzan
• Kylee Kleppen, RBT
• Erin N Kline
• Madison Knodel, PSYS NCSP
• Ashley Faye Knowlen
• Kori Knudson, PHYICAL THERAPIST
• Bryon Eugene Knutson, DC
• Michael F Knutson

• Registered Dietitian in Dickinson, ND
• Providers in Dickinson, ND by specialty
• Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.