Skip to content
NPISignal

Individual Healthcare Provider

Kathy Berdecia Doane, PHARMD, RPH, RDN

NPI Record: ActivePharmacist — Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
NPI1407996713
Eagan, Minnesota

Provider's NPPES record last updated: March 17, 2026

Overview

Entity Type
Individual Healthcare Provider
NPI
1407996713
Primary Specialty
Pharmacist — Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Practice Location
Eagan, Minnesota
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 21, 2026, 5:18 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Pharmacist

    Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

    Pharmacy Service Providers

    Primary

    Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.

    Taxonomy code 1835P0018X
  • Pharmacist

    Pharmacy Service Providers

    An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

    Taxonomy code 183500000X
  • Nutritionist

    Nutrition, Education

    Dietary & Nutritional Service Providers

    Definition to come...

    Taxonomy code 133NN1002X
  • Nutritionist

    Dietary & Nutritional Service Providers

    A specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the promotion of health. Nutritionists perform research, instruct groups and individuals about nutritional requirements, and assist people in developing meal patterns that meet their nutritional needs; (2) A nutritionist is someone who has completed undergraduate and/or graduate training in the discipline of nutrition without necessarily meeting the academic and experience requirements to qualify for the Registered Dietitian designation.

    Taxonomy code 133N00000X
  • Dietitian, Registered

    Dietary & Nutritional Service Providers

    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.

    Taxonomy code 133V00000X

Provider-Reported License Information

Pharmacist (Georgia)
RPH034170
Pharmacist (Massachusetts)
236242
Nutritionist (Puerto Rico)
1443
Nutritionist (Puerto Rico)
1443
Dietitian, Registered (Massachusetts)
2762
Pharmacist (Texas)
74157
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

Po Box 211699

Eagan, Minnesota 55121-3699

Phone: (866) 849-0692

Additional Practice Location

1049 Main St

Springfield, Massachusetts 01103

Phone: (413) 693-1005

Additional Practice Location

1128 S Park St

Carrollton, Georgia 30117-4450

Phone: (770) 836-0770

Additional Practice Location

230 Maple St

Holyoke, Massachusetts 01040-5144

Phone: (413) 420-2127

Fax: (413) 540-0957

Record Information

Enumeration Date
February 7, 2007
Provider's NPPES Record Last Updated
March 17, 2026
Certification Date
March 17, 2026
NPISignal NPPES Dataset
August 2026

See Something Wrong?

Incorrect provider information

Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.

Update a record through NPPES

Something wrong with this page?

If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.

Report a display issue