Active NPI
Andrew Winquist, RD
- Registered Dietitian
- Daytona Beach, FL
National Provider Identifier
1194258699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D10195117
- Practice address
- 330 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733 - Phone
- (386) 676-7133
- NPI assigned
- Apr 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D10195117 | OR | Primary |
| Registered Dietitian | 133V00000X | ND7771 | FL |
Addresses
Primary practice location
330 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Mailing address
1455 Laurel Ave
Coos Bay, OR 97420-2167
Phone (727) 409-0016
Other practice location 1
114 Palm Breeze Dr
Edgewater, FL 32141-5901
Phone (727) 409-0016
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND7771 | FL | MD | Registered Dietitian |
| LD-D10195117 | OR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proactive Nutrition & Wellness Inc | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | 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.
-
- Registered Dietitian
- Edgewater, FL
- NPI 1467075663
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1194258699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 LAUREL AVE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202167",
"telephone_number": "727-409-0016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142733",
"telephone_number": "386-676-7133"
}
],
"practiceLocations": [
{
"address_1": "114 Palm Breeze Dr",
"address_purpose": "LOCATION",
"city": "Edgewater",
"state": "FL",
"postal_code": "321415901",
"country_code": "US",
"telephone_number": "727-409-0016",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WINQUIST",
"first_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-11",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D10195117",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND7771",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.