Active NPI
Ashley Kim
- Registered Dietitian
- Lafayette, IN
National Provider Identifier
1972878486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37001945A
- Practice address
- 2600 Greenbush St
Lafayette, IN 47904-2477 - Phone
- (765) 448-8000
- NPI assigned
- Mar 16, 2012
- 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 | 37001945A | IN | Primary |
Addresses
Primary practice location
2600 Greenbush St
Lafayette, IN 47904-2477
Mailing address
PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000792842 | Other | IN | ANTHEM PROVIDER NUMBER |
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 |
|---|---|---|---|
| 37001945A | IN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sodexo Operations LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355961600000",
"number": "1972878486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5545",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479035545",
"telephone_number": "765-448-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 GREENBUSH ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042477",
"telephone_number": "765-448-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-16",
"last_updated": "2012-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37001945A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000792842",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.