Active NPI
Kourtney Patrick, MS, RD, LD
- Registered Dietitian
- Bloomington, IN
National Provider Identifier
1760364715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37003297A
- Practice address
- 1331 S Adams St Apt 8
Bloomington, IN 47403-2198 - Phone
- (812) 562-0757
- NPI assigned
- Jul 22, 2025
- Last updated
- Jul 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 37003297A | IN | Primary |
Addresses
Primary practice location
1331 S Adams St Apt 8
Bloomington, IN 47403-2198
Mailing address
1331 S Adams St Apt 8
Bloomington, IN 47403-2198
Phone (812) 562-0757
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37003297A | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753142400000",
"number": "1760364715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 S ADAMS ST APT 8",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032198",
"telephone_number": "812-562-0757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 S ADAMS ST APT 8",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032198",
"telephone_number": "812-562-0757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "KOURTNEY",
"credential": "MS, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-22",
"last_updated": "2025-07-22",
"certification_date": "2025-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37003297A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.