Individual provider Active NPI

Kelly Harrington, RDN

  • Registered Dietitian
  • Bend, OR
National Provider Identifier
1295182079
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-001035 Issued in OR
Practice address
516 SW 13TH St
Suite 101
Bend, OR 97702-3206
Phone
(541) 306-6801
NPI assigned
May 20, 2016
Last updated
May 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD-D-001035 OR Primary

Addresses

Primary practice location

516 SW 13TH St
Suite 101
Bend, OR 97702-3206

Mailing address

516 SW 13TH St
Suite 101
Bend, OR 97702-3206
Phone (541) 306-6801

Other identifiers 1

IdentifierTypeStateIssuer
46-4269404MedicaidOR

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD-D-001035ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lori S. Brizee Pediatric Nutrition Consultation LLC Dietitian, Registered CurrentSince Nov 14, 2017 Accepting new patients

Locations

516 SW 13th St
Ste 101
Bend, OR 97702
Phone (541) 306-6801

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1295182079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SW 13TH ST",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023206",
            "telephone_number": "541-306-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SW 13TH ST",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023206",
            "telephone_number": "541-306-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRINGTON",
        "first_name": "KELLY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-001035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46-4269404",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.