Individual provider Active NPI

Kari Lane, RD, CNSC

  • Registered Dietitian
  • Portland, ME
National Provider Identifier
1669949517
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI1318 Issued in ME
Practice address
636 Allen Ave
Portland, ME 04103-3706
Phone
(801) 913-7349
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 6331040-4901 UT
Registered Dietitian 133V00000X DI1318 ME Primary

Addresses

Primary practice location

636 Allen Ave
Portland, ME 04103-3706

Mailing address

636 Allen Ave
Portland, ME 04103-3706
Phone (801) 913-7349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200214001633 ME Practitioner - Registered Dietitian Or Nutrition Professional 0941636716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nutrition Works,LLCGroup PAC ID 8123091667, 5 clinicians

Practice addresses (Care Compare)

805 Stevens Ave
Portland, ME 04103-2647
Phone (207) 772-6279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI1318MEMDRegistered Dietitian
6331040-4901UTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Works,LLC Dietitian, Registered CurrentSince Jan 22, 2020 Accepting new patients

Locations

805 Stevens Ave
Portland, ME 04103
Phone (207) 772-6279

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": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1669949517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 ALLEN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033706",
            "telephone_number": "801-913-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 ALLEN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033706",
            "telephone_number": "801-913-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "KARI",
        "credential": "RD, CNSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "6331040-4901",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.