Individual provider Active NPI

Kayla Huslebus, RDN

  • Registered Dietitian
  • Eden Prairie, MN
National Provider Identifier
1669978672
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86054815 Issued in MN
Practice address
9600 Squire LN
Eden Prairie, MN 55347-3169
Phone
(952) 261-9843
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86054815 MN Primary

Addresses

Primary practice location

9600 Squire LN
Eden Prairie, MN 55347-3169

Mailing address

9600 Squire LN
Eden Prairie, MN 55347-3169
Phone (952) 261-9843

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

LicenseStateTypeSpecialty
86054815MNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1669978672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 SQUIRE LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553473169",
            "telephone_number": "952-261-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 SQUIRE LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553473169",
            "telephone_number": "952-261-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSLEBUS",
        "first_name": "KAYLA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "86054815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.