Active NPI
William Werthman, RD
- Registered Dietitian
- Fort Drum, NY
National Provider Identifier
1043982879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86109477
- Practice address
- 11050 Mt. Belvedere Boulevard
Fort Drum, NY 13602-5004 - Phone
- (734) 679-0933
- NPI assigned
- Sep 30, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 86109477 | Primary |
Addresses
Primary practice location
11050 Mt. Belvedere Boulevard
Fort Drum, NY 13602-5004
Mailing address
11050 Mt. Belvedere Boulevard
Fort Drum, NY 13602-5004
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1043982879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11050 MT. BELVEDERE BOULEVARD",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136025004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11050 MT. BELVEDERE BOULEVARD",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136025004",
"telephone_number": "734-679-0933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERTHMAN",
"first_name": "WILLIAM",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-30",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86109477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Drum, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.