Active NPI
Kathleen E Moran, RD
- Registered Dietitian
- Delta, CO
National Provider Identifier
1750777215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86062995
- Practice address
- 1501 E 3Rd St
Delta, CO 81416-2815 - Phone
- (970) 874-6410
- Fax
- (970) 399-2868
- NPI assigned
- Apr 11, 2015
- Last updated
- Apr 11, 2015
- 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 | 86062995 | CO | Primary |
Addresses
Primary practice location
1501 E 3Rd St
Delta, CO 81416-2815
Mailing address
PO Box 10100
Delta, CO 81416-0008
Phone (970) 874-2470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150512002655 | CO | Practitioner - Registered Dietitian Or Nutrition Professional | 0345569422 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86062995 | CO | MD | Registered Dietitian |
Interoperability endpoints
- kathleen.larson.1@12539.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428710400000",
"number": "1750777215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10100",
"city": "DELTA",
"state": "CO",
"postal_code": "814160008",
"telephone_number": "970-874-2470",
"fax_number": "970-874-2475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 E 3RD ST",
"city": "DELTA",
"state": "CO",
"postal_code": "814162815",
"telephone_number": "970-874-6410",
"fax_number": "970-399-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "KATHLEEN",
"middle_name": "E",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-11",
"last_updated": "2015-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86062995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delta, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2015; 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.