Active NPI
Katherine Elizabeth Hennemann, RD, LD, CNSC
- Registered Dietitian
- West Burlington, IA
National Provider Identifier
1376830166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 01393
- Practice address
- 1401 W Agency Rd
West Burlington, IA 52655-1659 - Phone
- (319) 768-4100
- Fax
- (319) 768-3412
- NPI assigned
- Jun 30, 2011
- 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 | 01393 | IA | Primary |
Addresses
Primary practice location
1401 W Agency Rd
West Burlington, IA 52655-1659
Mailing address
1401 W Agency Rd
West Burlington, IA 52655-1659
Phone (319) 768-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134168263 | Other | IA | HOSPITAL NPI # |
Other names 1
- Katherine Elizabeth Boward
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 |
|---|---|---|---|
| 01393 | IA | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1376830166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 W AGENCY RD",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551659",
"telephone_number": "319-768-4100",
"fax_number": "319-768-3412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W AGENCY RD",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551659",
"telephone_number": "319-768-4100",
"fax_number": "319-768-3412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNEMANN",
"first_name": "KATHERINE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "RD, LD, CNSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "01393",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOSPITAL NPI #",
"identifier": "1134168263",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "BOWARD",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.