Jackie L Havel, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2615-29 Issued in WI

Practice address

525 Airport Dr
Oneida, WI 54155-9035

Phone

(920) 869-2711

Fax

(920) 869-1782

NPI assigned

Jan 4, 2018

Last updated

Jan 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1003323692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "ONEIDA",
            "state": "WI",
            "postal_code": "541550365",
            "telephone_number": "920-869-2711",
            "fax_number": "920-869-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 AIRPORT DR",
            "city": "ONEIDA",
            "state": "WI",
            "postal_code": "541559035",
            "telephone_number": "920-869-2711",
            "fax_number": "920-869-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEL",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2615-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina L Erickson, OTR
• Michael Flood, MD
• Lisa Frechette, DDS
• Marie-Andree Claudette Gelinas, D.C.
• Jason Gospodarek, OD
• Healthy Living Chiropractic Clinic Inc. (Hobart Family Chiropractic)
• Susan Higgs, RD
• Betsy Hoida, PHARMD
• Divya Hotchandani, MD
• Alyssa J Hudak, RD CD

• Registered Dietitian in Oneida, WI
• Providers in Oneida, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.