Kidney Nutrition Consult, LLC

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

Legal business name

KIDNEY NUTRITION CONSULT, LLC

Practice address

285 Victory Rd
Quincy, MA 02171-3137

Phone

(617) 320-2804

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Haewook Han, PHD,RD,CSR,LDNNPI 1053506618

Title

Owner

Phone

(617) 320-2804

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

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

• Haewook Han, PHD, RD, CSR, LDN

  • Renal Nutrition Registered Dietitian
  • Boston, MA
  • NPI 1053506618

  Nutrition, Renal

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1659956241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 VICTORY RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021713137",
            "telephone_number": "617-320-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 VICTORY RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021713137",
            "telephone_number": "617-320-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY NUTRITION CONSULT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "HAEWOOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-320-2804",
        "authorized_official_credential": "PHD,RD,CSR,LDN"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed Khairallah
• Jamila Khan, EDD
• Saima S Khan, MD
• Ruth E. Khowais, PSY.D.
• Dinna Khoy, PMHNP-BC
• Marybeth Kilcommons
• Kathleen Kilcoyne
• Kelli Killoren, NP
• Stephen Killourhy
• Padraic Kilroy, M.A.

• Renal Nutrition Registered Dietitian in Quincy, MA
• Providers in Quincy, MA by specialty
• Renal Nutrition Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.