Individual provider Active NPI

Patricia B Urbanski, MED, RD, LD,CNSD,CDE

  • Registered Dietitian
  • Duluth, MN
National Provider Identifier
1689656142
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
330 N 8TH Ave E
Duluth, MN 55805-2024
Phone
(218) 723-1112
Fax
(218) 529-9120
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Nutrition Education Nutritionist 133NN1002X
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

330 N 8TH Ave E
Duluth, MN 55805-2024

Mailing address

330 N 8TH Ave E
Duluth, MN 55805-2024
Phone (218) 723-1112

Other identifiers 1

IdentifierTypeStateIssuer
962135000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028001523 MN Practitioner - Registered Dietitian Or Nutrition Professional 5890989339 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
1503MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Sep 1, 2015 Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Sep 1, 2015 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1689656142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112",
            "fax_number": "218-529-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N 8TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052024",
            "telephone_number": "218-723-1112",
            "fax_number": "218-529-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANSKI",
        "first_name": "PATRICIA",
        "middle_name": "B",
        "credential": "MED, RD, LD,CNSD,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "962135000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.