Michelle Petkovsek, RDN, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

5001-29 Issued in WI

Practice address

2000 N Dewey Ave
Reedsburg, WI 53959-1049

Phone

(608) 768-6129

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710

  WI

  Medicare reassignment NPD
• Reedsburg Area Medical Center Inc

  • Rural Health Clinic/Center
  • La Valle, WI
  • NPI 1437049566
  NPD
• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983
  NPD
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1851936785

  Health Educator

  NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1114647203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 GRANITE AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591874",
            "telephone_number": "608-768-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N DEWEY AVE",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591049",
            "telephone_number": "608-768-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETKOVSEK",
        "first_name": "MICHELLE",
        "credential": "RDN, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "WI",
            "license": "5001-29",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "5001-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicky Pasholk, PHARM D
• Patricia Passehl, APNP, FNP-C
• Diane S Pautzke
• Delaney Peterson
• Traci L. Peterson, D.C.
• Jessica Phalen, RN
• Katie M Porter, PA-C, ATC
• Danielle Powell
• Powerback Rehabilitation LLC
• Joe G Prell, O.D.

• All providers in Reedsburg, WI
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.