Active NPI
Jaime L Popenhagen
- Nutritionist
- Genoa City, WI
National Provider Identifier
1053652602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- Practice address
- 112 Elizabeth LN
Genoa City, WI 53128-2124 - Phone
- (262) 279-2800
- NPI assigned
- Mar 6, 2013
- Last updated
- Mar 6, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NU | Primary |
Addresses
Primary practice location
112 Elizabeth LN
Genoa City, WI 53128-2124
Mailing address
1400 Hunters Ridge Dr
#45
Genoa City, WI 53128-2532
Phone (815) 276-8872
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": "1362528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1053652602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 HUNTERS RIDGE DR",
"address_2": "#45",
"city": "GENOA CITY",
"state": "WI",
"postal_code": "531282532",
"telephone_number": "815-276-8872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 ELIZABETH LN",
"city": "GENOA CITY",
"state": "WI",
"postal_code": "531282124",
"telephone_number": "262-279-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPENHAGEN",
"first_name": "JAIME",
"middle_name": "L",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Genoa City, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.