KELLY SORACCO (NPI# 1407466766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407466766 |
| Entity Type | Individual |
| Full Name | KELLY SORACCO |
| Credential | RDN |
| Practice Address |
1234 E Dupont Rd Ste 3 Fort Wayne IN 46825-1545 |
| Mailing Address |
11109 Parkview Plaza Drive Mailbox 117 Fort Wayne IN 46845-1701 |
| Practice Telephone | 2604255970 |
| Mailing Telephone | 2602668210 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 37001137A | IN | Dietary & Nutritional Service Providers |
| Street Address |
1234 E DUPONT RD STE 3 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619141124 | Vicki Dishon | Physician Assistant | 1234 E Dupont Rd Ste 3, Fort Wayne, IN 46825-1545 | 2008-04-15 |
| 1043760424 | Deanna Lynn Vaughn | Nurse Practitioner | 1234 E Dupont Rd Ste 3, Fort Wayne, IN 46825 | 2016-10-10 |
| 1053795096 | Erin Elise Peer | Nurse Practitioner | 1234 E Dupont Rd Ste 3, Fort Wayne, IN 46825 | 2015-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| 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 |
|---|---|---|---|---|
| 1366043002 | Lauren Neuenschwander | Dietitian, Registered | 10017 Schuyler Ct, Fort Wayne, IN 46804-4377 | 2020-11-07 |
| 1154981389 | Rebecca Paden | Dietitian, Registered | 1315 Directors Row Ste 210, Fort Wayne, IN 46808-1284 | 2019-06-19 |
| 1821592221 | Katherine Hake | Dietitian, Registered | 2220 Lima Plank Pkwy, Fort Wayne, IN 46818-8968 | 2018-03-20 |
| 1730533852 | Charlene Ann Burian | Dietitian, Registered | 3213 Twisted Branch Pl, Fort Wayne, IN 46804-3436 | 2016-04-14 |
| 1164880746 | Kandi Denise Dawson | Dietitian, Registered | 2520 E. Dupont Rd, Nutrition Services, Fort Wayne, IN 46825 | 2016-02-10 |
| 1437517083 | Julie West | Dietitian, Registered | 2520 East Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-02-10 |
| 1972968295 | Alison Johnson | Dietitian, Registered | 1833 Midsummer Night Cv, Fort Wayne, IN 46818-8469 | 2015-12-31 |
| 1053776344 | Tiane Bianski | Dietitian, Registered | 6322 Farmswood Drive Apt 1b, Fort Wayne, IN 46804 | 2015-12-31 |
| 1750623591 | Courtney Rinehold | Dietitian, Registered | 1607 Glacier Ridge Rd, Fort Wayne, IN 46845-9720 | 2013-03-19 |
| 1346541562 | Diane E Glass | Dietitian, Registered | 11141 Parkview Plaza Dr Ste 305b, Fort Wayne, IN 46845-1713 | 2010-11-04 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on KELLY SORACCO.
| 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.