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NPI Code Detail

MEDICARE: M. KATHRYN KEOGH MS, RDN, LD

MEDICARE: M. KATHRYN KEOGH MS, RDN, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianL006004NC
2133V00000XRegistered Dietitian3099AL
3133V00000XRegistered DietitianLD005468GA
4133V00000XRegistered Dietitian2446KS
5133V00000XRegistered Dietitian2009SC
6133V00000XRegistered DietitianDN-0011113DE
7133VN1004XPediatric Nutrition Registered DietitianLD.7274OH
8133VN1005XRenal Nutrition Registered DietitianLD.7274OH
9133VN1006XMetabolic Nutrition Registered DietitianLD.7274OH
10133V00000XRegistered DietitianLD.7274OH

General Provider Information

NPI Number : 1811342108
Entity Type Code : Individual
Provider Name (Legal Business Name) : M. KATHRYN KEOGH MS, RDN, LD
Provider Business Mailing Address
First Line : PO BOX 830242
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19182-0242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1014 VINE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1141
Country : US
Telephone Number : 855-699-6937
Fax Number : 800-546-2104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2016
Last Update Date : 04/18/2025

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