Individual provider Active NPI

Brandi Keown, REGISTERED DIETITIAN

  • Registered Dietitian
  • Evansville, IN
National Provider Identifier
1366611535
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
873976 Issued in IN
Practice address
515 Read St
Evansville, IN 47710-1739
Phone
(812) 450-6044
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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 873976 IN Primary

Addresses

Primary practice location

515 Read St
Evansville, IN 47710-1739

Mailing address

2911 Oak Trail Dr
Newburgh, IN 47630-9117
Phone (812) 490-2097

Other identifiers 1

IdentifierTypeStateIssuer
282N00000XMedicaidIN

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

LicenseStateTypeSpecialty
873976INMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1366611535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 OAK TRAIL DR",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309117",
            "telephone_number": "812-490-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-450-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "BRANDI",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "873976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282N00000X",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.