Individual provider Active NPI

Katharine Lee Patel, RD

  • Registered Dietitian
  • Springfield, IL
National Provider Identifier
1316390909
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.006867 Issued in IL
Practice address
520 N 4TH St
Springfield, IL 62702-5238
Phone
(217) 545-8000
Fax
(217) 757-8161
NPI assigned
Jul 19, 2016
Last updated
May 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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 164.006867 IL Primary

Addresses

Primary practice location

520 N 4TH St
Springfield, IL 62702-5238

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbeberman193516@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161007000763 IL Practitioner - Registered Dietitian Or Nutrition Professional 8325336381 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164.006867ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince May 1, 2023 Accepting new patients
Sodexo Operations LLC Dietitian, Registered CurrentSince Sep 3, 2016 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince May 1, 2023 Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

115 Pheasant Run
Ste 106
Newtown, PA 18940

Interoperability endpoints

  • Direct secure messaging: kbeberman193516@ewd.direct.hshs.org

Organizations & group practices 4

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1316390909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025238",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KATHARINE",
        "middle_name": "LEE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbeberman193516@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1118 W Legacy Pointe Dr",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627116444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.