Individual provider Active NPI

Melissa A Phillips, RD

  • Registered Dietitian
  • Madison, WI
National Provider Identifier
1194857805
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1734-029 Issued in WI
Practice address
700 S Park St
Madison, WI 53715-1830
Phone
(608) 260-6000
Fax
(608) 260-2977
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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 1734-029 WI Primary

Addresses

Primary practice location

700 S Park St
Madison, WI 53715-1830

Mailing address

700 S Park St
Madison, WI 53715-1830
Phone (608) 260-6000

Other identifiers 1

IdentifierTypeStateIssuer
60707OtherWIDEAN HEALTH INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050607001295 WI Practitioner - Registered Dietitian Or Nutrition Professional 5991747032 Reassigns benefits to 1 organization
I20240508001171 TX Practitioner - Registered Dietitian Or Nutrition Professional 5991747032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1734-029WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 24, 2020 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Dec 24, 2020 Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Mar 11, 2024 Accepting new patients

Locations

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

4602 Eastpark Blvd
Madison, WI 53718
Phone (608) 263-7540

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1194857805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-6000",
            "fax_number": "608-260-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1734-029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60707",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.