Active NPI
Katharine Lee Patel, RD
- Registered Dietitian
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006867
- 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, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.006867 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Sodexo Operations LLC | Dietitian, Registered | Current | Accepting new patients |
| Board of Trustees of Southern Illinois University | Current | 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
- 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.
-
dba Siu Center for Family Medicine
- Primary Care Clinic/Center
- Springfield, IL
- NPI 1396097960
-
dba SIU Center for Family Medicine - Care-A-Van
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1568210425
-
dba Community Nursing Services
- Clinic/Center
- E Saint Louis, IL
- NPI 1306273776
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.