Active NPI
Kaitlyn Havenner, RD
- Registered Dietitian
- Fort Collins, CO
National Provider Identifier
1699518563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86359653
- Practice address
- 333 W Drake Rd Ste 131
Fort Collins, CO 80526-6319 - Phone
- (708) 717-7394
- NPI assigned
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 86359653 | CO | Primary |
Addresses
Primary practice location
333 W Drake Rd Ste 131
Fort Collins, CO 80526-6319
Mailing address
2557 Limon Dr Unit 4
Fort Collins, CO 80525-7667
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86359653 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Happy Healthy | Dietitian, Registered | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1699518563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2557 LIMON DR UNIT 4",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805257667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W DRAKE RD STE 131",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805266319",
"telephone_number": "708-717-7394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVENNER",
"first_name": "KAITLYN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86359653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.