Active NPI
Kristi Marie Flicker, LD
- Registered Dietitian
- Coeur D Alene, ID
National Provider Identifier
1376839191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- D-585
- Practice address
- 3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689 - Phone
- (208) 765-9100
- Fax
- (208) 765-9103
- NPI assigned
- Jun 20, 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 | D-585 | ID | Primary |
Addresses
Primary practice location
3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689
Mailing address
3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689
Phone (208) 765-9100
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-585 | ID | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1376839191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3320 N GRAND MILL LN",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838145689",
"telephone_number": "208-765-9100",
"fax_number": "208-765-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 N GRAND MILL LN",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838145689",
"telephone_number": "208-765-9100",
"fax_number": "208-765-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLICKER",
"first_name": "KRISTI",
"middle_name": "MARIE",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ID",
"license": "D-585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.