Individual provider Active NPI

Kelsea O'Rourke

  • Registered Dietitian
  • Buffalo, NY
National Provider Identifier
1699508093
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
011425 Issued in NY
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 826-1000
NPI assigned
Aug 21, 2024
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 011425 NY Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

2157 Main St
Attn: Clinical Nutrition Department
Buffalo, NY 14214-2648

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1699508093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "address_2": "ATTN: CLINICAL NUTRITION DEPARTMENT",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-826-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "KELSEA",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.