Active NPI
Kelsey Marie Raab
- Registered Dietitian
- Miller, SD
National Provider Identifier
1689181364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 0614
- Practice address
- 300 W 5TH St
Miller, SD 57362-1238 - Phone
- (605) 853-2421
- Fax
- (605) 853-0333
- NPI assigned
- Jan 4, 2018
- Last updated
- Nov 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 0614 | SD | Primary |
Addresses
Primary practice location
300 W 5TH St
Miller, SD 57362-1238
Mailing address
904 E Donlin St
Miller, SD 57362-1654
Phone (605) 870-1036
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0614 | SD | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 605 Dietitian, LLC | Dietitian, Registered | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1689181364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 E DONLIN ST",
"city": "MILLER",
"state": "SD",
"postal_code": "573621654",
"telephone_number": "605-870-1036",
"fax_number": "605-853-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 5TH ST",
"city": "MILLER",
"state": "SD",
"postal_code": "573621238",
"telephone_number": "605-853-2421",
"fax_number": "605-853-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAAB",
"first_name": "KELSEY",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-04",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SD",
"license": "0614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miller, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.