Active NPI
Tracey Kmiecik, MPH, RD
- Registered Dietitian
- Seattle, WA
National Provider Identifier
1366068744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 60912554
- Practice address
- 5450 Leary Ave NW Apt 643
Seattle, WA 98107-4081 - Phone
- (714) 943-5530
- NPI assigned
- Jun 22, 2020
- 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 | 60912554 | WA | Primary |
Addresses
Primary practice location
5450 Leary Ave NW Apt 643
Seattle, WA 98107-4081
Mailing address
5450 Leary Ave NW Apt 643
Seattle, WA 98107-4081
Phone (206) 614-0010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60912554 | WA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Humankind Nutrition PLLC | Dietitian, Registered | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1366068744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5450 LEARY AVE NW APT 643",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981074081",
"telephone_number": "206-614-0010",
"fax_number": "206-614-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5450 LEARY AVE NW APT 643",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981074081",
"telephone_number": "714-943-5530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KMIECIK",
"first_name": "TRACEY",
"credential": "MPH, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "60912554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.