Active NPI
Kathryn Kjorstad Smith, RD
- Registered Dietitian
- Toledo, OH
National Provider Identifier
1295830149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L 115
- Practice address
- 3333 Glendale Ave
Toledo, OH 43614-2426 - Phone
- (419) 259-2000
- Fax
- (419) 259-2008
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | L 115 | OH | Primary |
Addresses
Primary practice location
3333 Glendale Ave
Toledo, OH 43614-2426
Mailing address
7121 Crabtree LN
Sylvania, OH 43560-1107
Phone (419) 885-2781
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LD 115 | Other | OH | BOARD OF DIETETICS LICENS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L 115 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295830149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7121 CRABTREE LN",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435601107",
"telephone_number": "419-885-2781",
"fax_number": "419-885-2781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 GLENDALE AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436142426",
"telephone_number": "419-259-2000",
"fax_number": "419-259-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KATHRYN",
"middle_name": "KJORSTAD",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "L 115",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF DIETETICS LICENS",
"identifier": "LD 115",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.