Active NPI
Elizabeth Wedman-St. Louis, PHD
- Registered Dietitian
- Redington Shores, FL
National Provider Identifier
1043596927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1455
- Practice address
- 17920 Gulf Blvd
Ste 606
Redington Shores, FL 33708 - Phone
- (727) 391-6198
- Fax
- (727) 399-2188
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1455 | FL | Primary |
Addresses
Primary practice location
17920 Gulf Blvd
Ste 606
Redington Shores, FL 33708
Mailing address
17920 Gulf Blvd
Ste 606
Redington Shores, FL 33708
Phone (727) 391-6198
Other names 1
- Dr. Betty Wedman-St. Louis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1455 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1043596927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17920 GULF BLVD",
"address_2": "STE 606",
"city": "REDINGTON SHORES",
"state": "FL",
"postal_code": "33708",
"telephone_number": "727-391-6198",
"fax_number": "727-399-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17920 GULF BLVD",
"address_2": "STE 606",
"city": "REDINGTON SHORES",
"state": "FL",
"postal_code": "33708",
"telephone_number": "727-391-6198",
"fax_number": "727-399-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDMAN-ST. LOUIS",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "1455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BETTY",
"last_name": "WEDMAN-ST. LOUIS",
"prefix": "DR.",
"credential": "PHD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Redington Shores, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.