Individual provider Active NPI

Miranda Knutson

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Apple Valley, MN
National Provider Identifier
1336010792
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
Practice address
14800 Galaxie Ave
Apple Valley, MN 55124-4520
Phone
(952) 777-3366
NPI assigned
Sep 17, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X Primary

Addresses

Primary practice location

14800 Galaxie Ave
Apple Valley, MN 55124-4520

Mailing address

3495 Northdale Blvd NW Ste 100
Coon Rapids, MN 55448-6713
Phone (763) 210-2608

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

Practice roles

OrganizationSpecialtyStatusNew patients
Livea Medical PLLC CurrentSince Sep 21, 2025 Accepting new patients

Locations

3495 Northdale Blvd NW
Ste 100
Coon Rapids, MN 55448
Phone (763) 210-2608

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": "1758067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1336010792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 NORTHDALE BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554486713",
            "telephone_number": "763-210-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244520",
            "telephone_number": "952-777-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.