Active NPI
Natasha Wilcox, RD
- Registered Dietitian
- Fairlawn, OH
National Provider Identifier
1083275754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86064189
- Practice address
- 352 Owosso Ave
Fairlawn, OH 44333-3744 - Phone
- (866) 237-6125
- NPI assigned
- Jun 24, 2019
- 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 | 86064189 | OH | Primary |
Addresses
Primary practice location
352 Owosso Ave
Fairlawn, OH 44333-3744
Mailing address
352 Owosso Ave
Fairlawn, OH 44333-3744
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86064189 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Emily Program PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Seattle, WA
- NPI 1154696698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1083275754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 OWOSSO AVE",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 OWOSSO AVE",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333744",
"telephone_number": "866-237-6125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "NATASHA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-24",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "86064189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.