Active NPI
Kimberly Colegrove, RD
- Registered Dietitian
- Reno, NV
National Provider Identifier
1821649294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 10085 Double R Blvd Ste 325
Reno, NV 89521-4832 - Phone
- (775) 982-5073
- Fax
- (775) 982-3958
- NPI assigned
- Sep 26, 2019
- 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 | Primary |
Addresses
Primary practice location
10085 Double R Blvd Ste 325
Reno, NV 89521-4832
Mailing address
850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191122001688 | NV | Practitioner - Registered Dietitian Or Nutrition Professional | 2264864693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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": "1569456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1821649294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HARVARD WAY",
"city": "RENO",
"state": "NV",
"postal_code": "895022055",
"telephone_number": "775-982-5262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10085 DOUBLE R BLVD STE 325",
"city": "RENO",
"state": "NV",
"postal_code": "895214832",
"telephone_number": "775-982-5073",
"fax_number": "775-982-3958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEGROVE",
"first_name": "KIMBERLY",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-26",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.