Kathryn Koller, RD. LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

37004107A Issued in IN

Practice address

412 S Scott Rd
Fort Wayne, IN 46814-9702

Phone

(260) 358-7180

NPI assigned

Apr 2, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Neossia Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1295396810
  NPD (past)

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1942004585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 PREMIER AVE APT 101",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467140077",
            "telephone_number": "216-952-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S SCOTT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149702",
            "telephone_number": "260-358-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "KATHRYN",
        "credential": "RD. LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37004107A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Frederick Kolch, D. MIN.
• Miranda Ellen Renee Kolde, MSW
• Kaleigh Koler
• George Robert Kolettis, MD
• George T Kolettis, M.D.
• Anuradha Kollipara, M.D
• Praveen Kollipara, MD
• Sai Anudeep Kollipara, MD
• Srilekha Kollipara, MD
• Takefumi Komiya, MD, PHD

• Registered Dietitian in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.