Individual provider Active NPI

Marjorie L. Stuckwisch, RD

  • Registered Dietitian
  • Mount Pleasant, WI
National Provider Identifier
1205014610
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2015-029 Issued in WI
Practice address
3805A Spring St
Mount Pleasant, WI 53405-1600
Phone
(262) 687-4011
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT82069 TX
Registered Dietitian 133V00000X 2015-029 WI Primary

Addresses

Primary practice location

3805A Spring St
Mount Pleasant, WI 53405-1600

Mailing address

3805A Spring St
Mount Pleasant, WI 53405-1600
Phone (262) 687-4011

Other practice location 1

6500 N Mopac
BLDG III,Ste 220
Austin, TX 78731-3282
Phone (512) 338-4500

Other identifiers 2

IdentifierTypeStateIssuer
966937OtherRD NUMBER
8DF186OtherTXBCBS OF TEXAS

Other names 1

  • Marjorie L Oakes Former name

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

State licenses

LicenseStateTypeSpecialty
DT82069TXMDRegistered Dietitian
2015-029WIMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Shelley Madsen & Associates, Inc. Dietitian, Registered PastSince Jan 20, 2006 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1205014610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805A SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051600",
            "telephone_number": "262-687-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805A SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534051600",
            "telephone_number": "262-687-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 N Mopac",
            "address_2": "BLDG III,STE 220",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787313282",
            "country_code": "US",
            "telephone_number": "512-338-4500",
            "fax_number": "512-338-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCKWISCH",
        "first_name": "MARJORIE",
        "middle_name": "L.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT82069",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2015-029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD NUMBER",
            "identifier": "966937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8DF186",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "OAKES",
            "middle_name": "L",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.