Audra Wilson, MS, RDN

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

164006665 Issued in IL

Practice address

300 Randall Rd Ste 100
Geneva, IL 60134-4200

Phone

(630) 933-3513

NPI assigned

Feb 20, 2020

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

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Surgical Care of Northern Illinois, LTDGroup PAC ID 0547298374, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Advanced Surgical Care of Northern Illinois, LTD

  • Surgery Physician
  • Barrington, IL
  • NPI 1922169291
  Medicare reassignment Care Compare group NPD
• Alter Clinical Services LLC

  • Clinical Psychologist
  • St Charles, IL
  • NPI 1033732003
  NPD (past)
• Cloud Health Medical Group of New Jersey, P.C.

  • Internal Medicine Physician
  • Union City, NJ
  • NPI 1043995467
  NPD (past)
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1073146874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 RITA AVE",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601744441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD STE 100",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-933-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AUDRA",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "IL",
            "license": "164006665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William P. Burke Jr. P.C.
• Gretchen K Williams, PT
• Hovey Ellis Williams III, M.S.
• Kurt J Williams, M.D.
• Susan Williams, LCPC
• Kathryn Winans, MS, RD, LDN
• Adam R Winckler, D.D.S.
• Windmill Counseling, LLC (Windmill Counseling)
• Lora D Windsor, LCSW, CADC
• Courtney Winkle, DC

• Obesity and Weight Management Nutrition Registered Dietitian in Geneva, IL
• Providers in Geneva, IL by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.