Active NPI
Kelsey Marie McCourt, RDN
- Registered Dietitian
- Morro Bay, CA
National Provider Identifier
1477215697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86074251
- Practice address
- 2598 Main St
Morro Bay, CA 93442-1553 - Phone
- (805) 225-7302
- NPI assigned
- Oct 6, 2021
- 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 | 86074251 | CA | Primary |
Addresses
Primary practice location
2598 Main St
Morro Bay, CA 93442-1553
Mailing address
2450 Victoria Ave Unit 101
San Luis Obispo, CA 93401-5758
Phone (702) 553-5579
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86074251 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marlena Tanner, RDN, LLC | Dietitian, Registered | Current | Accepting new patients |
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": "1633478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1477215697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 VICTORIA AVE UNIT 101",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934015758",
"telephone_number": "702-553-5579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2598 MAIN ST",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "934421553",
"telephone_number": "805-225-7302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOURT",
"first_name": "KELSEY",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-06",
"last_updated": "2021-10-06",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86074251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morro Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.