Active NPI
Emma Hubbard
- Registered Dietitian
- Columbus, WI
National Provider Identifier
1124800784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5331
- Practice address
- 1515 Park Ave
Columbus, WI 53925-2402 - Phone
- (920) 623-2200
- NPI assigned
- Oct 18, 2023
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5331 | WI | Primary |
Addresses
Primary practice location
1515 Park Ave
Columbus, WI 53925-2402
Mailing address
1515 Park Ave
Columbus, WI 53925-2402
Phone (920) 623-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231113000737 | WI | Practitioner - Registered Dietitian Or Nutrition Professional | 6800243833 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200
Hospital & facility affiliations
- Columbus Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5331 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Ridge Health Inc. | Current | Accepting new patients | |
| Prairie Ridge Health, Inc. | Current | Accepting new patients | |
| Prairie Ridge Health, Inc. | Current | Accepting new patients |
Locations
1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Sun Prairie, WI
- NPI 1699534545
-
- Primary Care Clinic/Center
- Marshall, WI
- NPI 1477005544
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1124800784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 PARK AVE",
"city": "COLUMBUS",
"state": "WI",
"postal_code": "539252402",
"telephone_number": "920-623-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 PARK AVE",
"city": "COLUMBUS",
"state": "WI",
"postal_code": "539252402",
"telephone_number": "920-623-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "EMMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-18",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "5331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.