Individual provider Active NPI

Brian A Keppen, RD

  • Registered Dietitian
  • Barron, WI
National Provider Identifier
1619937604
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1572 Issued in WI
Practice address
1222 E Woodland Ave
Barron, WI 54812-1765
Phone
(715) 838-5222
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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 1572 WI Primary

Addresses

Primary practice location

1222 E Woodland Ave
Barron, WI 54812-1765

Mailing address

1222 E Woodland Ave
Barron, WI 54812-1765
Phone (715) 838-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkeppen32183@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000735 WI Practitioner - Registered Dietitian Or Nutrition Professional 6608802939 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1572WIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince May 6, 2021 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince May 6, 2021 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

2049 15th Ave
Cameron, WI 54822
Phone (715) 458-4380

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Interoperability endpoints

  • Direct secure messaging: bkeppen32183@ehrdirect.mayoclinicmsg.org

Organizations & group practices 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1619937604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPEN",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkeppen32183@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1222 E Woodland Ave",
            "city": "Barron",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548121765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Barron, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.