KODY MICHAEL DUCLOS RD, LD
NPI 1033748124
Dietitian, Registered - Nutrition, Pediatric in Boise, ID

Q: What is Kody Duclos's NPI number?

The NPI number for Kody Duclos is 1033748124. It was assigned to this individual provider in the NPPES registry on April 2, 2020.

Q: What is Kody Duclos's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

Q: When was this NPI record last updated?

The NPPES record for Kody Duclos was last updated on April 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 02, 2020

305 E JEFFERSON ST, BOISE, ID 83712(208) 381-7081 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kody Michael Duclos Rd, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KODY MICHAEL DUCLOS RD, LD (NPI 1033748124) is an individual nutrition, pediatric provider in Boise, Idaho, licensed in Idaho (86117056) and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1033748124

Entity TypeIndividualMale

Primary Taxonomy133VN1004X

Provider Legal NameKODY MICHAEL DUCLOSCredential: RD, LD

Location Address305 E JEFFERSON STBoise, ID 83712-6231

Mailing Address5176 W Mercury CtBoise, ID 83705-3746 · (208) 507-5656

Phone(208) 381-7081

Sole ProprietorNo

Enumeration DateApril 2, 2020

NPPES CertifiedApril 2, 2020

✔ NPI 1033748124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDietitian, Registered · Nutrition, PediatricDietary & Nutritional Service Providers

Taxonomy Code133VN1004X

License✔ Licensed in ID · 86117056

Definition

An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.

Also ListedDietitian, Registered · Nutrition, OncologyTaxonomy 133VN1301X · License 86117056 (ID)

Also ListedDietitian, Registered · Nutrition, Pediatric Critical CareTaxonomy 133VN1401X · License 86117056 (ID)

305 E JEFFERSON ST, Boise, ID 83712

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Other Identifiers 1

Other86117056ID · Commission On Dietetic Registration

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAILEY LIZABETH COLLETTE MS

Dietitian, Registered (Nutrition, Pediatric)