Individual provider Active NPI

Anne Marie Vollrath, RD

  • Registered Dietitian
  • Green Bay, WI
National Provider Identifier
1083699441
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1122 Issued in WI
Practice address
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone
(920) 430-4700
NPI assigned
Dec 8, 2005
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1122 WI Primary

Addresses

Primary practice location

1630 Commanche Ave
Green Bay, WI 54313-5753

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other practice location 1

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 435-8326

Other practice location 2

2641 Development Dr
Green Bay, WI 54311-4240
Phone (920) 338-6868

Other practice location 3

720 S VanBuren St
Suite 101
Green Bay, WI 54301
Phone (920) 433-3420

Other practice location 4

575 4th St
Kewaunee, WI 54216-1785
Phone (920) 388-4640

Other practice location 5

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

Other identifiers 2

IdentifierTypeStateIssuer
20910421OtherNATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS
709289OtherCOMMISSION ON DIETETIC REGISTRATION

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1083699441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-430-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135751",
            "country_code": "US",
            "telephone_number": "920-435-8326",
            "fax_number": "920-430-4659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2641 Development Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543114240",
            "country_code": "US",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 S VanBuren St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "54301",
            "country_code": "US",
            "telephone_number": "920-433-3420",
            "fax_number": "920-338-6859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 4th St",
            "address_purpose": "LOCATION",
            "city": "Kewaunee",
            "state": "WI",
            "postal_code": "542161785",
            "country_code": "US",
            "telephone_number": "920-388-4640",
            "fax_number": "920-388-0479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLLRATH",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS",
            "identifier": "20910421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "709289",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.