Kimberly Louise Johnson, R.D.L.D.,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1748 Issued in MN

Practice address

750 E 34TH St
Hibbing, MN 55746-2341

Phone

(218) 362-6608

Fax

(218) 362-6617

NPI assigned

Apr 4, 2007

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

• Ms. Kimberly Louise Fairchild Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295857886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462341",
            "telephone_number": "218-362-6608",
            "fax_number": "218-362-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462341",
            "telephone_number": "218-362-6608",
            "fax_number": "218-362-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "R.D.L.D.,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "1748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FAIRCHILD",
            "middle_name": "LOUISE",
            "prefix": "MS.",
            "credential": "R.D.L.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrecia Taplin Jacobson, DDS
• Dawn Bremer Jenkins, MSSW LICSW
• John L Bonner Eye Clinic LTD
• Anita K Johnson-Hoehne, CNP
• Dana Ruthe Johnson
• Mark Johnson
• Meredith Q Johnson, RD/LD
• Richard A. Johnson, DDS
• Brekke Lee Johnsrud, DDS, MPH
• Ashley C Joki, ADT

• Registered Dietitian in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Registered Dietitian in Minnesota

• 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.

Verify at the official NPI Registry.