Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1881083699 Individual Practitioner Female Practitioner

Kristen Bourque , RD, LD, CLC

Dietitian, Registered • Indianapolis, IN

Professional Overview & Biography Verified Profile Summary

Kristen Bourque, RD, LD, CLC is a registered healthcare professional specializing in Dietitian, Registered in Indianapolis, IN. Practice services are available at 9115 HAGUE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9115 Hague Rd

Indianapolis, IN 462561025

Telephone 3175212000
Associated Practice Facility / Clinic
🏢 Roche Diabetes Care Inc Facility NPI 1710980156

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Indianapolis, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.4 Yrs
State Avg: 18.3 Yrs
Regional Practice Density
265 Specialists

Practicing in Indianapolis, IN (1231 Statewide)

Telehealth Adoption Rate
7.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-12-15
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License IL 164.007743

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Dietitian, Registered

NUCC Taxonomy Code: 133V00000X

State License NV 32149DI-0

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Marla Kinnaman , NP

Nurse Practitioner - Family

NPI 1356325484

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location December 15, 2021

Registered at 9115 HAGUE RD, INDIANAPOLIS, IN 462561025 (Tel: 3175212000)

📍
Updated Business Mailing Address December 15, 2021

Registered at 7408 W PALATINE AVE, CHICAGO, IL 606311920 (Tel: 7022507901)

NPI Profile Active April 07, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location April 07, 2015

Registered at 2716 N TENAYA WAY, LAS VEGAS, NV 891280424 (Tel: 7028775356)

📍
Updated Business Mailing Address April 07, 2015

Registered at 2716 N TENAYA WAY, LAS VEGAS, NV 891280424

👤
Provider Name / Credentials Updated April 07, 2015

Recorded as KRISTEN BOURQUE, RD, LD, CLC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 07, 2015

Dietitian, Registered (License #32149DI-0 in NV)

🟢
Initial NPI Registration & Enumeration January 16, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881083699
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2015
Last Update: December 15, 2021
Sole Proprietor: No

Mailing Address

7408 W Palatine Ave

Chicago, IL 606311920

Phone: 7022507901

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.