Active NPI
Katherine M Lebarre, R.D
- Registered Dietitian
- Grand Rapids, MI
National Provider Identifier
1932255502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 811102
- Practice address
- 4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292 - Phone
- (616) 267-7414
- NPI assigned
- Jan 26, 2007
- 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 | 811102 | MI | Primary |
Addresses
Primary practice location
4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292
Mailing address
100 Michigan St NE
MC 109
Grand Rapids, MI 49503-2560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 811102 | MI | MD | Registered Dietitian |
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1932255502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 109",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 LAKE DR SE STE 205",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468292",
"telephone_number": "616-267-7414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBARRE",
"first_name": "KATHERINE",
"middle_name": "M",
"credential": "R.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "811102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.