Tara Ketner, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86212286 Issued in IL

Practice address

920 West St
Peru, IL 61354-2763

Phone

(815) 780-3520

NPI assigned

Jul 14, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1417529900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 PROSPECT ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541563",
            "telephone_number": "815-883-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542763",
            "telephone_number": "815-780-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETNER",
        "first_name": "TARA",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86212286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.ketner@ivch.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "920 West St",
            "city": "Peru",
            "state": "IL",
            "country_code": "US",
            "postal_code": "613542763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Kelly Jones
• Joseph Kunnel DDS, PHD, PC
• Jill Kamphaus
• Connor Kasik
• Patcharaporn Keane, PHARMD
• Alison Jeanne Kibilka, CRNA
• Won Yang Kim, M.D.
• Robert S Kinsella, D.O.
• Kamal Kishore, M.D.
• Gary Joseph Kistenfeger, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.