Kathleen A Brandt, R.D.
Individual provider Active NPI Registered Dietitian · Eugene, OR
NPI 1649202029 · NPPES record last updated Jul 5, 2011
Key facts
- NPI
- 1649202029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 552 (OR)
- Practice address
- 1200 Hilyard St
Suite 550
Eugene, OR 97401-8122 - Phone
- (541) 686-7029
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110502000564 | OR | Practitioner - Registered Dietitian Or Nutrition Professional | 8820273121 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 552 | OR | Yes |
Addresses
Primary practice location
1200 Hilyard St
Suite 550
Eugene, OR 97401-8122
Mailing address
PO Box 24410
Eugene, OR 97402-0451
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100236 | Medicaid | OR |
Other providers in Eugene, OR
- Aiden Brahn-Perrot
- Heidi Michelle Brancato
- Drew Shaddeau Brandel
- Gary E Brandt
- Jacqulene Brandt
- Lindsey Braney
- Naomi Branham
- Janet Branson
- Tylore H Branton
- Amelia Brasch
All providers in Eugene, OR · Registered Dietitian in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.