KC Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-D-10177506 Issued in OR

Legal business name

KC NUTRITION, LLC

Practice address

1693 SW Chandler Ave Ste 140
Bend, OR 97702-3230

Phone

(541) 279-3696

NPI assigned

Jan 8, 2018

Organization subpart

No

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

Authorized official

Name

Kristina Coughlin, MS, RDN, LD

Title

Owner

Phone

(541) 279-3696

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1689181976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6232",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 SW CHANDLER AVE STE 140",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023230",
            "telephone_number": "541-279-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "COUGHLIN",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-279-3696",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "CA",
            "license": "01013025",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10177506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT HEALTH AND HUMAN SERVICES",
            "identifier": "1801333935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill R Kaufmann, MS
• Mehama Elizabeth Kaupp
• Kellie Michiko Kawasaki-Jones
• Deanna Kay
• Noreen Kaye, LCSW
• KD Endo, LLC
• Christopher Keane, MD
• Patrick Kearns
• Tamarind Marie Keating, ARNP, MPH
• Richard S Kebler, M.D.

• Registered Dietitian in Bend, OR
• Providers in Bend, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.