Jan Kielmann, MS, CNS, IFMCP

Primary specialty

NutritionistTaxonomy code 133N00000X

License

NU 60611293 Issued in WA

Practice address

112 E Olive Ave Ste F
Redlands, CA 92373-5281

Phone

(909) 810-0858

NPI assigned

Jan 25, 2016

Last updated

Sep 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science

State licenses

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

• Natural Health

  dba Functional Wellness

  • Nutritionist
  • Redlands, CA
  • NPI 1861920720
  Authorized official Same address or phone

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1740647593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 HIGHLAND SPRINGS AVE",
            "city": "CHERRY VALLEY",
            "state": "CA",
            "postal_code": "922235548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E OLIVE AVE STE F",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735281",
            "telephone_number": "909-810-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELMANN",
        "first_name": "JAN",
        "name_prefix": "Mr.",
        "credential": "MS, CNS, IFMCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-25",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU 60611293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Linh H. Khuu, M.D.
• Sheila Elizabeth Killingsworth-Thomas, CADC-I
• Eliot Kim
• Henry Kim, DDS
• Hyun Jung Kim, D.D.S.
• James Jaeyoung Kim, DPT

• Nutritionist in Redlands, CA
• Providers in Redlands, CA by specialty
• Nutritionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.