Kelly Rae McGraw, MS, LN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

N183 Issued in MN

Practice address

123 Village Center Dr
North Oaks, MN 55127-3007

Phone

(651) 773-0000

Fax

(651) 695-0191

NPI assigned

Apr 5, 2022

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1346981131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SNELLING AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046842",
            "telephone_number": "651-699-3428",
            "fax_number": "651-695-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 VILLAGE CENTER DR",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551273007",
            "telephone_number": "651-773-0000",
            "fax_number": "651-695-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "KELLY",
        "middle_name": "RAE",
        "credential": "MS, LN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MN",
            "license": "N183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "address",
            "affiliation": "N",
            "endpointDescription": "address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "123 Village Center Dr",
            "city": "North Oaks",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551273007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nutritionist in North Oaks, MN
• Providers in North Oaks, MN by specialty
• Nutritionist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.