Individual provider Active NPI

Katrina Marie Sweeney

  • Nutritionist
  • Boulder, CO
National Provider Identifier
1275298002
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
2260 Baseline Rd Ste 102
Boulder, CO 80302-7740
Phone
(720) 899-0195
NPI assigned
Nov 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133N00000X Primary

Addresses

Primary practice location

2260 Baseline Rd Ste 102
Boulder, CO 80302-7740

Mailing address

11555 W 106TH Way
Westminster, CO 80021-6673
Phone (215) 859-0024

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Charm Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1275298002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 W 106TH WAY",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216673",
            "telephone_number": "215-859-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 BASELINE RD STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803027740",
            "telephone_number": "720-899-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "KATRINA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Charm",
            "affiliation": "N",
            "endpointDescription": "Electronic Health Record and Patient Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "2260 Baseline Rd Ste 102",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803027740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.