K.SHAN PERFORMANCE LLC. (NPI# 1023637642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023637642 |
| Entity Type | Organization |
| Organization Name | K.SHAN PERFORMANCE LLC. |
| Practice Address |
1130 W Broad St Ste 101 Bethlehem PA 18018-4926 |
| Practice Telephone | 4845549638 |
| Mailing Telephone | 4845549638 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | KYLE SHANNON (MANAGING MEMBER/OWNER) |
| Authorized Official Telephone | 4848942631 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
Dietary & Nutritional Service Providers | ||
| N | 133VN1201X | ||||
| N | 133VN1501X | ||||
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Other Name | Type Code |
|---|---|
| KSP Fitness | Doing Business As Name - Organization |
| Street Address |
1130 W BROAD ST STE 101 |
| City | BETHLEHEM |
| State | PA |
| Zip Code | 18018-4926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871130591 | Kyle Shannon | Dietitian, Registered | 1130 W Broad St Ste 101, Bethlehem, PA 18018-4926 | 2019-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373292 | Jade Madison Hennessy | Specialist/Technologist | Moravian College, 1200 Main Street, Bethlehem, PA 18018 | 2019-06-03 |
| 1780106179 | Courtney Jane Kruscavage | Specialist/Technologist | 641 Dellwood Street, Bethlehem, PA 18018 | 2017-07-07 |
| 1205357936 | Balanced Body Therapeutic Massage, LLC | Massage Therapist | 227 W Broad St Ste 102, Bethlehem, PA 18018 | 2017-07-03 |
| 1033567599 | Jessamine Martin | Counselor | 1 East Broad Street, Suite 510, Bethlehem, PA 18018 | 2016-05-25 |
| 1841650041 | Akhi Saha | Internal Medicine | 325 W Broad St Fl 1, Bethlehem, PA 18018 | 2016-03-01 |
| 1063804193 | Paul Minh Le | Internal Medicine | 800 Eaton Ave Ste B, Bethlehem, PA 18018 | 2015-02-26 |
| 1578962841 | Elizabeth Veronica Weiss Iobst | Counselor | 1754 W. Broad St., Bethlehem, PA 18018 | 2014-08-22 |
| 1255771739 | Inner Resources Counseling Inc | Counselor | 807 West Broad St, Bethlehem, PA 18018 | 2013-06-28 |
| 1437404878 | St Luke Hospital | General Acute Care Hospital | 1956 C Allwood Dr., Bethlehem, PA 18018 | 2012-07-23 |
| 1275802944 | St. Luke's Physician Group, Inc | Ophthalmology | 800 Eaton Avenue, Suite 101, Bethlehem, PA 18018 | 2011-12-23 |
| Find all providers in zip 18018 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487260675 | Victoria L Kaleycik | Dietitian, Registered | 4112 Maria Ln, Bethlehem, PA 18017-8406 | 2020-09-22 |
| 1871130591 | Kyle Shannon | Dietitian, Registered | 1130 W Broad St Ste 101, Bethlehem, PA 18018-4926 | 2019-12-02 |
| 1740766302 | Rhianna Lyn Cenci | Dietitian, Registered | 1130 W Broad St, Bethlehem, PA 18018-4926 | 2018-07-17 |
| 1013525443 | Amanda Blair Stone | Dietitian, Registered | 2545 Schoenersville Rd, Bethlehem, PA 18017-7300 | 2020-07-22 |
| 1851856835 | Dana Michelle Pammer | Dietitian, Registered | 4250 Fritch Dr, Bethlehem, PA 18020-9412 | 2019-02-05 |
| 1205320330 | Mallory Knoll | Dietitian, Registered | 2300 Highland Ave, Bethlehem, PA 18020 | 2018-06-21 |
| 1952817041 | Rachel Ann Lovewell | Dietitian, Registered | 419 W Broad St, Bethlehem, PA 18018-5562 | 2017-12-27 |
| 1912429325 | Victoria Leigh Hinman | Dietitian, Registered | 3365 High Point Blvd, Bethlehem, PA 18017-7806 | 2017-07-07 |
| 1053860403 | Lori Ahdieh | Dietitian, Registered | 2855 Schoenersville Rd, Clinical Nutrition, Bethlehem, PA 18017-7306 | 2016-09-27 |
| 1689123101 | Leslie Billowitch | Dietitian, Registered | 2855 Schoenersville Rd, Bethlehem, PA 18017-7306 | 2016-09-26 |
| Find all providers in BETHLEHEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.