Active NPI
Kim Schott
- Registered Dietitian
- Lakeport, CA
National Provider Identifier
1649848565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86110508
- Practice address
- 831 Bevins St
Lakeport, CA 95453-9755 - Phone
- (707) 263-5253
- NPI assigned
- Jun 16, 2021
- 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 | 86110508 | CA | Primary |
Addresses
Primary practice location
831 Bevins St
Lakeport, CA 95453-9755
Mailing address
9495 Tenaya Way
Kelseyville, CA 95451-9646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86110508 | Other | CA | COMMISSION ON DIETETIC REGISTRATION (CDR) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86110508 | CA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Growell | Dietitian, Registered | Current | 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": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1649848565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9495 TENAYA WAY",
"city": "KELSEYVILLE",
"state": "CA",
"postal_code": "954519646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 BEVINS ST",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954539755",
"telephone_number": "707-263-5253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHOTT",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-16",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86110508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION (CDR)",
"identifier": "86110508",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.