Active NPI
Kathryn Mennillo, R.D.,CDN
- Registered Dietitian
- Saratoga Springs, NY
National Provider Identifier
1821126582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 960097
- Practice address
- 211 Church St
Saratoga Springs, NY 12866-1046 - Phone
- (518) 583-8668
- NPI assigned
- Mar 2, 2007
- 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 | 960097 | NY | Primary |
Addresses
Primary practice location
211 Church St
Saratoga Springs, NY 12866-1046
Mailing address
51 E. High St.
Ballston Spa, NY 12020
Phone (518) 322-5083
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 960097 | NY | MD | Registered Dietitian |
| 006298 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821126582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 E. HIGH ST.",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "12020",
"telephone_number": "518-322-5083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 CHURCH ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661046",
"telephone_number": "518-583-8668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNILLO",
"first_name": "KATHRYN",
"name_prefix": "Mrs.",
"credential": "R.D.,CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "960097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.