Individual provider Active NPI

Kathryn Brown, RDN, LDN

  • Registered Dietitian
  • Round Lake, IL
National Provider Identifier
1962874297
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.006550 Issued in IL
Practice address
325 W Caldwell Dr
Round Lake, IL 60073-4294
Phone
(847) 609-6654
NPI assigned
Oct 26, 2015
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 86012436 IL
Registered Dietitian 133V00000X 164.006550 IL Primary

Addresses

Primary practice location

325 W Caldwell Dr
Round Lake, IL 60073-4294

Mailing address

325 W Caldwell Dr
Round Lake, IL 60073-4294
Phone (847) 609-6654

Other practice location 1

1500 Robin Cir
Apt 314
Hoffman Estates, IL 60169-1152
Phone (847) 609-6654

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
164.006550ILMDRegistered Dietitian
86012436ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1962874297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W CALDWELL DR",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600734294",
            "telephone_number": "847-609-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W CALDWELL DR",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600734294",
            "telephone_number": "847-609-6654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Robin Cir",
            "address_2": "Apt 314",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691152",
            "country_code": "US",
            "telephone_number": "847-609-6654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KATHRYN",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86012436",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.