Katherine J Ellefson, RD,CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

3236 Issued in MN

Practice address

6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300

Phone

(952) 285-2840

NPI assigned

Oct 17, 2014

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capernaum Pediatric Therapy, Inc.

  • Specialist
  • Richfield, MN
  • NPI 1619978228
  NPD

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1689078834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 RIVER RD",
            "city": "DRESSER",
            "state": "WI",
            "postal_code": "540094203",
            "telephone_number": "715-417-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 430",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232300",
            "telephone_number": "952-285-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEFSON",
        "first_name": "KATHERINE",
        "middle_name": "J",
        "credential": "RD,CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2694-29",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "1055136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ehlers and Keller DDS PA
• Donald Charles Ehlers, DDS
• Katherine Marie Eiden, OTR/L
• Brian T Eipperle, PT
• Elizabeth McPeek LLC
• Rebecca Jane Ellmann, MA, LPCC
• Emerald Therapy LLC
• Encouraging Life Resources
• Enjoy the Journey Counseling
• Jessica Enneking, LMFT

• Registered Dietitian in Richfield, MN
• Providers in Richfield, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.