Active NPI
Kirsten Gram, RD,LD,CDE
- Registered Dietitian
- Eugene, OR
National Provider Identifier
1891719928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 140
- Practice address
- 2650 Suzanne Way Ste 200
Eugene, OR 97408-7619 - Phone
- (541) 228-3022
- Fax
- (541) 228-3181
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 140 | OR | Primary |
Addresses
Primary practice location
2650 Suzanne Way Ste 200
Eugene, OR 97408-7619
Mailing address
2650 Suzanne Way Ste 200
Eugene, OR 97408-7619
Phone (541) 228-3022
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16751 | Other | OR | REGISTERED DIETITIAN |
| 0902-9189 | Other | OR | CERTIFIED DIABETES ED. |
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 |
|---|---|---|---|
| 140 | OR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1891719928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 SUZANNE WAY STE 200",
"city": "EUGENE",
"state": "OR",
"postal_code": "974087619",
"telephone_number": "541-228-3022",
"fax_number": "541-228-3181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 SUZANNE WAY STE 200",
"city": "EUGENE",
"state": "OR",
"postal_code": "974087619",
"telephone_number": "541-228-3022",
"fax_number": "541-228-3181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAM",
"first_name": "KIRSTEN",
"name_prefix": "Ms.",
"credential": "RD,LD,CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITIAN",
"identifier": "16751",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED DIABETES ED.",
"identifier": "0902-9189",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.