Kay M Osadjan, R.D.,L.D.N.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164002345 Issued in IL

Practice address

5666 E State St
Rockford, IL 61108-2425

Phone

(815) 226-2000

NPI assigned

May 12, 2008

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

Other names 1

• Kay M Blackburn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1366619173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-226-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-226-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSADJAN",
        "first_name": "KAY",
        "middle_name": "M",
        "credential": "R.D.,L.D.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164002345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "BLACKBURN",
            "middle_name": "M",
            "credential": "R.D.,L.D.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Rockford, IL
• Providers in Rockford, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.