Individual provider Active NPI

Kristen Mshar, R.D., L.D.N., C.D.E.

  • Registered Dietitian
  • Hinsdale, IL
National Provider Identifier
1497153829
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164001052 Issued in IL
Practice address
40 S Clay St Ste 210
Hinsdale, IL 60521-3257
Phone
(630) 789-8890
Fax
(630) 789-8892
NPI assigned
Dec 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 164001052 IL Primary

Addresses

Primary practice location

40 S Clay St Ste 210
Hinsdale, IL 60521-3257

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other practice location 1

120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-8006

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmshar265698@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204002042 IL Practitioner - Registered Dietitian Or Nutrition Professional 1951759752 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164001052ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Oct 23, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 23, 2023 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

40 S Clay St
Ste 210
Hinsdale, IL 60521
Phone (630) 323-3540

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: kmshar265698@dulyhealthandcare.direct-ci.com

Organizations & group practices 2

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": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1497153829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S CLAY ST STE 210",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213257",
            "telephone_number": "630-789-8890",
            "fax_number": "630-789-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 N Oak St",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213829",
            "country_code": "US",
            "telephone_number": "630-856-8006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MSHAR",
        "first_name": "KRISTEN",
        "credential": "R.D., L.D.N., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164001052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmshar265698@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "40 S Clay St Ste 210",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.

Verify at the official NPI Registry.