Individual provider Active NPI

Heather Robinson, RDN

  • Registered Dietitian
  • Ashtabula, OH
National Provider Identifier
1417523119
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86118373 Issued in OH
Practice address
4200 State Rd
Ashtabula, OH 44004-6017
Phone
(440) 998-7515
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD.09392 OH
Registered Dietitian 133V00000X 86118373 OH Primary

Addresses

Primary practice location

4200 State Rd
Ashtabula, OH 44004-6017

Mailing address

4200 State Rd
Ashtabula, OH 44004-6017
Phone (440) 998-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220503001482 OH Practitioner - Registered Dietitian Or Nutrition Professional 1850795345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86118373OHMDRegistered Dietitian
LD.09392OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ka Wellness and Nutrition LLC Dietitian, Registered CurrentSince Oct 1, 2024 Accepting new patients

Locations

718 E 3rd St
Salem, OH 44460
Phone (330) 333-8990

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1417523119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046017",
            "telephone_number": "440-998-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 STATE RD",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046017",
            "telephone_number": "440-998-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.09392",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "86118373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.