Kellie Koswick, RD, CLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86020817 Issued in CO

Practice address

1000 Lincoln St
CS 4200
Fort Morgan, CO 80701-3290

Phone

(970) 542-3321

Fax

(970) 867-7972

NPI assigned

Nov 2, 2016

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 2, 2016.

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1558813832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN ST",
            "address_2": "CS 4200",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013290",
            "telephone_number": "970-542-3321",
            "fax_number": "970-867-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN ST",
            "address_2": "CS 4200",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013290",
            "telephone_number": "970-542-3321",
            "fax_number": "970-867-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSWICK",
        "first_name": "KELLIE",
        "name_prefix": "Ms.",
        "credential": "RD, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86020817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wolf Keller, PA-C
• Kenneth Keller, M.D.
• Shenae Marcene Kembel
• Kenneth Keller MD PC
• Lora Kopp-Mahluza, LAC, LPC
• Donald Gale Kruglet, M.D.
• Andrea Lynn L'Heureux, LPC
• Bridget Langello
• Paula Kay Laporte, BSN, RN
• Lawrence Schoelkopf MD PC

• All providers in Fort Morgan, CO
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.