Keelie Korsness, MSC, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86017100 Issued in NU

Practice address

260 SW Madison Ave Ste 109
Corvallis, OR 97333-4728

Phone

(545) 190-8731

NPI assigned

Jan 4, 2020

Last updated

Jan 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1912546177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26760 FUDGE RD",
            "city": "ALSEA",
            "state": "OR",
            "postal_code": "973249412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SW MADISON AVE STE 109",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334728",
            "telephone_number": "545-190-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORSNESS",
        "first_name": "KEELIE",
        "credential": "MSC, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-04",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10192004",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "86017100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Kolka, IDC
• Rachel Suzanne Kollen
• Angela Marie Koning, LPC
• Rob Koning
• Kerin S Konkler, NP
• Collin Korthauer
• James Robert Koski, MD, MPH
• Amber Lynn Kovich
• Wayne A Kradjan, PHARM.D.
• Shawn Kraft

• Registered Dietitian in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; 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.