Active NPI
Mary Gannon Kaufmann, RD
- Registered Dietitian
- Cedar Rapids, IA
National Provider Identifier
1467875609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 002182
- Practice address
- 1026 A Ave NE
Cedar Rapids, IA 52402-5036 - Phone
- (319) 369-7440
- NPI assigned
- Jan 23, 2014
- Last updated
- Jan 23, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 002182 | IA | Primary |
Addresses
Primary practice location
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Mailing address
7124 Chelsea Dr NE
Cedar Rapids, IA 52402-1471
Phone (319) 447-1381
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, CO
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002182 | IA | MD | Speech-Language Pathologist |
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": "1390435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1467875609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7124 CHELSEA DR NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524021471",
"telephone_number": "319-447-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 A AVE NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025036",
"telephone_number": "319-369-7440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMANN",
"first_name": "MARY",
"middle_name": "GANNON",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-23",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "002182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.