1154345916 NPI number — MRS. KAYLA O'GRADY RAMOTAR MS, RD, CDN, CSCS

Table of content: MRS. KAYLA O'GRADY RAMOTAR MS, RD, CDN, CSCS (NPI 1154345916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154345916 NPI number — MRS. KAYLA O'GRADY RAMOTAR MS, RD, CDN, CSCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOTAR
Provider First Name:
KAYLA
Provider Middle Name:
O'GRADY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, CDN, CSCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EVANS
Provider Other First Name:
KAYLA
Provider Other Middle Name:
O'GRADY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, RD, CDN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154345916
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10262 SILVER STIRRUP DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80925-1342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-592-9660
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 COCHRANE CIR
Provider Second Line Business Practice Location Address:
BLDG 7500
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-4613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-524-5733
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  006107-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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