Individual provider Active NPI

Kathryn Ingrid Poppe, RDN

  • Registered Dietitian
  • Yellow Springs, OH
National Provider Identifier
1407214950
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD7891 Issued in OH
Practice address
4359 E Enon Rd
Yellow Springs, OH 45387-9708
Phone
(937) 206-1131
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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 LD7891 OH Primary

Addresses

Primary practice location

4359 E Enon Rd
Yellow Springs, OH 45387-9708

Mailing address

4359 E Enon Rd
Yellow Springs, OH 45387-9708

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

LicenseStateTypeSpecialty
LD7891OHMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1407214950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4359 E ENON RD",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453879708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4359 E ENON RD",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453879708",
            "telephone_number": "937-206-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPPE",
        "first_name": "KATHRYN",
        "middle_name": "INGRID",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD7891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yellow Springs, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.