Active NPI
Majedah Y Koetter-Ali, RD
- Registered Dietitian
- Louisville, KY
National Provider Identifier
1427435999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 162884
- Practice address
- 907 Lyndon LN
Louisville, KY 40222-3815 - Phone
- (502) 425-7659
- Fax
- (502) 425-7658
- NPI assigned
- May 4, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | BDNDTN00218429 | KY | |
| Registered Dietitian | 133V00000X | 162884 | KY | Primary |
Addresses
Primary practice location
907 Lyndon LN
Louisville, KY 40222-3815
Mailing address
907 Lyndon LN
Louisville, KY 40222-3815
Phone (502) 425-7659
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000945941 | Other | KY | ANTHEM |
Other names 1
- Maji Ali
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Interoperability endpoints
- mkoetterali86097@bhkydirect.com
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482364800000",
"number": "1427435999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 LYNDON LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402223815",
"telephone_number": "502-425-7659",
"fax_number": "502-425-7658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 LYNDON LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402223815",
"telephone_number": "502-425-7659",
"fax_number": "502-425-7658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOETTER-ALI",
"first_name": "MAJEDAH",
"middle_name": "Y",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-04",
"last_updated": "2016-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "BDNDTN00218429",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "162884",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000945941",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAJI",
"last_name": "ALI",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.