Gregory Wisont, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

60974846 Issued in WA

Practice address

12901 20TH Ave S
Seatac, WA 98168-5159

Phone

(206) 720-3987

Fax

(206) 292-2163

NPI assigned

Jun 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gregory Wibert Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Kidney CentersGroup PAC ID 5799673679, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Kidney Centers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Seatac, WA
  • NPI 1700025038
  Medicare reassignment Care Compare group NPD
• Northwest Kidney Centers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Kent, WA
  • NPI 1588378533
  NPD

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1013692771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16910 NE 131ST PL",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522189",
            "telephone_number": "360-969-3698",
            "fax_number": "206-292-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 20TH AVE S",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981685159",
            "telephone_number": "206-720-3987",
            "fax_number": "206-292-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISONT",
        "first_name": "GREGORY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "60974846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CD",
            "identifier": "60974846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "WIBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Watson Chiropractic, P.S.
• Peter Watson, LMHCA
• Wellnesspoint Labs LLC
• Tatiana Weyrick
• Marcee Wickline, AUD, CCC-A
• Richard Yo Yuan Wu, DDS
• Patrick Xu
• Barlin Farole Yarow
• Deirdre Yen
• Gregory Calvin Yen, DDS

• Registered Dietitian in Seatac, WA
• Providers in Seatac, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.