Individual provider Active NPI

Lindsay Frank Keeney, RD, LD, CD, CNSC

  • Registered Dietitian
  • Glendale, WI
National Provider Identifier
1851607113
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3185-29 Issued in WI
Practice address
5261 N Port Washington Rd Ste 201
Glendale, WI 53217-4903
Phone
(206) 948-8810
Fax
(503) 893-3038
NPI assigned
Aug 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2932 MN
Registered Dietitian 133V00000X 3185-29 WI Primary

Addresses

Primary practice location

5261 N Port Washington Rd Ste 201
Glendale, WI 53217-4903

Mailing address

8837 N Iroquois Rd
Bayside, WI 53217-1712

Other practice location 1

8837 N Iroquois Rd
Bayside, WI 53217-1712
Phone (503) 494-5466

Other identifiers 2

IdentifierTypeStateIssuer
2932OtherMNDIETETIC LICENSURE
3185-29OtherWICERTIFIED DIETITIAN

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

LicenseStateTypeSpecialty
3185-29WIMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851607113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8837 N IROQUOIS RD",
            "city": "BAYSIDE",
            "state": "WI",
            "postal_code": "532171712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 N PORT WASHINGTON RD STE 201",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174903",
            "telephone_number": "206-948-8810",
            "fax_number": "503-893-3038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8837 N Iroquois Rd",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "WI",
            "postal_code": "532171712",
            "country_code": "US",
            "telephone_number": "503-494-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENEY",
        "first_name": "LINDSAY",
        "middle_name": "FRANK",
        "credential": "RD, LD, CD, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2932",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "3185-29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETETIC LICENSURE",
            "identifier": "2932",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIETITIAN",
            "identifier": "3185-29",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.