Individual provider Active NPI

Kristina Swanson, RDN, LDN

  • Registered Dietitian
  • Woodbury, MN
National Provider Identifier
1750948535
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT88512 Issued in TX
Practice address
1733 Orchard Dr
Woodbury, MN 55125-8647
Phone
(612) 499-6015
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 4110 MN
Registered Dietitian 133V00000X 164.008826 IL
Registered Dietitian 133V00000X 2022013309 MO
Registered Dietitian 133V00000X 1632 NE
Registered Dietitian 133V00000X 3861 WI
Registered Dietitian 133V00000X 112011 IA
Registered Dietitian 133V00000X 0836 SD
Registered Dietitian 133V00000X 2718 KS
Registered Dietitian 133V00000X MN
Registered Dietitian 133V00000X DT88512 TX Primary

Addresses

Primary practice location

1733 Orchard Dr
Woodbury, MN 55125-8647

Mailing address

1733 Orchard Dr
Woodbury, MN 55125-8647
Phone (612) 499-6015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623002632 TX Practitioner - Registered Dietitian Or Nutrition Professional 2567820483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1632NEMDMental Health Counselor
3861WIMDGeneral Practice Dentistry
112011IAMDRegistered Dietitian
164.008826ILMDRegistered Dietitian
2718KSMDRegistered Dietitian
4110MNMDRegistered Dietitian
2022013309MOMDRegistered Dietitian
0836SDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Jul 1, 2023 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

515 S Flower St
#1015
Los Angeles, CA 90071

8605 Santa Monica Blvd
#320298
West Hollywood, CA 90069

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

401 N Michigan Ave
Ste 1200
Chicago, IL 60611
Phone (224) 496-6940

3499 Blazer Pkwy
Ste 330
Lexington, KY 40509
Phone (410) 885-4727

525 N Tryon St
Ste 1600
Charlotte, NC 28202
Phone (855) 478-8208

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

1806 Highway 35
Ste 203A
Oakhurst, NJ 07755

10260 SW Greenburg Rd
#4
Portland, OR 97223
Phone (513) 845-1656

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1750948535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 ORCHARD DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258647",
            "telephone_number": "612-499-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 ORCHARD DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258647",
            "telephone_number": "612-499-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "KRISTINA",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4110",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.008826",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2022013309",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "1632",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "3861",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "112011",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SD",
            "license": "0836",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "2718",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.