KELLY MANNER (NPI# 1710511282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710511282 |
| Entity Type | Individual |
| Full Name | KELLY MANNER |
| Credential | RD |
| Practice Address |
1601 Golf Course Rd Grand Rapids MN 55744-8648 |
| Mailing Address |
3868 Maple Hill Rd Hibbing MN 55746-8340 |
| Practice Telephone | 2189991671 |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-02-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 958365 | MN | Dietary & Nutritional Service Providers |
| Street Address |
1601 GOLF COURSE RD |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-8648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326023060 | Jack Victor Carlisle | Family Medicine | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2005-12-14 |
| 1568076602 | Tyler Wesley Waller | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-09-05 |
| 1699397042 | Tiffany Alicia Axtman | Nurse Practitioner | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2020-05-08 |
| 1285273292 | Patrick James Nelson | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-12-23 |
| 1801446943 | Natalie Jo Castle | Physician Assistant | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-09-19 |
| 1578121356 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-06-05 |
| 1487210233 | Jake Heggem | Pharmacist | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-05-17 |
| 1902379159 | Grand Itasca Clinic and Hospital | Pharmacy | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-01-09 |
| 1548768534 | Michelle Overbye | Nurse Practitioner | 1601 Golf Course Rd, Grand Rapids, MN 55744 | 2018-01-25 |
| 1922457969 | Angela Degrio | Obstetrics & Gynecology | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2016-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| 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 |
|---|---|---|---|---|
| 1316575988 | Sarah Flessner | Dietitian, Registered | 100 Michigan St Ne # Mc84, Grand Rapids, MI 49503-2560 | 2020-03-30 |
| 1790311025 | Mitchell Paul Mrozik | Dietitian, Registered | 3308 Statesman Ct Ne, Grand Rapids, MI 49525-2685 | 2020-03-18 |
| 1881224665 | Darleena Scholten | Dietitian, Registered | 4520 Bonneville Dr Ne, Grand Rapids, MI 49525-1315 | 2020-01-22 |
| 1306320577 | Elizabeth Ames Eggleston | Dietitian, Registered | 7508 Whispering Ridge St Se, Grand Rapids, MI 49546-9168 | 2018-09-24 |
| 1457706707 | Patricia Ann Tucker | Dietitian, Registered | 4490 Bonanza Dr Ne, Grand Rapids, MI 49525-6848 | 2016-04-24 |
| 1477911352 | Rachel Laughlin | Dietitian, Registered | 4201 Kings Row Ct Nw, Grand Rapids, MI 49534-3495 | 2016-02-05 |
| 1922483809 | Stacey Niesen | Dietitian, Registered | 2215 44th St Se, Grand Rapids, MI 49508-5013 | 2015-07-21 |
| 1174944888 | Laura Brechting | Dietitian, Registered | 4 Union Ave Ne, Grand Rapids, MI 49503-3430 | 2013-12-23 |
| 1154769941 | Nancy Ann Ullrey | Dietitian, Registered | 3596 Tricklewood Dr Se, Grand Rapids, MI 49546-7246 | 2013-06-13 |
| 1104173251 | Denise Lynn Kesterke | Dietitian, Registered | 1450 Fulton St E, Grand Rapids, MI 49503-3854 | 2012-08-08 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
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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.