Radish Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

RADISH NUTRITION LLC

Practice address

212 S 11TH St Ste 4B
Coeur D Alene, ID 83814-4000

Phone

(925) 818-9399

NPI assigned

Nov 13, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Meghan Konegni, MS, RD, CSR, LDNPI 1912635368

Title

Owner

Phone

(925) 818-9399

Specialties & licenses 1

Addresses

Other names 1

• LLC Other name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Meghan Konegni, MS, RD, CSR, LD

  • Renal Nutrition Registered Dietitian
  • Coeur D Alene, ID
  • NPI 1912635368

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1659195857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E FERNAN CT",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145803",
            "telephone_number": "925-818-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S 11TH ST STE 4B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144000",
            "telephone_number": "925-818-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADISH NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "KONEGNI",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MEGHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-818-9399",
        "authorized_official_credential": "MS, RD, CSR, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Jason B Ramsrud, LMSW
• Brandi R Randles
• Kerissa Ransbury

• Registered Dietitian in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Registered Dietitian in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.