Courtney Kyle, MS, RD, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

61141161 Issued in WA

Practice address

1761 N Willamette Rd
Liberty Lake, WA 99016-5058

Phone

(509) 671-2462

NPI assigned

Dec 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1689333890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 N WILLAMETTE RD",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990165058",
            "telephone_number": "509-671-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 N WILLAMETTE RD",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990165058",
            "telephone_number": "509-671-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLE",
        "first_name": "COURTNEY",
        "credential": "MS, RD, CD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "61141161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.