Active NPI
Taylor Peters
- Registered Dietitian
- Kankakee, IL
National Provider Identifier
1558607341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164005801
- Practice address
- 500 W Court St
Kankakee, IL 60901-3661 - Phone
- (815) 937-2445
- NPI assigned
- Dec 24, 2012
- 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 | 164005801 | IL | Primary |
Addresses
Primary practice location
500 W Court St
Kankakee, IL 60901-3661
Mailing address
500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2445
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164005801 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sodexo Operations LLC | Dietitian, Registered | Past | 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": "1356307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356307200000",
"number": "1558607341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W COURT ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609013661",
"telephone_number": "815-937-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W COURT ST",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609013661",
"telephone_number": "815-937-2445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-24",
"last_updated": "2012-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164005801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.