Individual provider Active NPI

Kimberly Ann Nanninga, RD, LD

  • Registered Dietitian
  • West Des Moines, IA
National Provider Identifier
1447589403
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
001905 Issued in IA
Practice address
1725 Jordan Creek Pkwy
West Des Moines, IA 50266-5876
Phone
(515) 223-7389
Fax
(515) 221-9355
NPI assigned
Dec 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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 001905 IA Primary

Addresses

Primary practice location

1725 Jordan Creek Pkwy
West Des Moines, IA 50266-5876

Mailing address

1725 Jordan Creek Pkwy
West Des Moines, IA 50266-5876
Phone (515) 223-7389

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1447589403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 JORDAN CREEK PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665876",
            "telephone_number": "515-223-7389",
            "fax_number": "515-221-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 JORDAN CREEK PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665876",
            "telephone_number": "515-223-7389",
            "fax_number": "515-221-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNINGA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "001905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.