Individual provider Active NPI

Karen Elaina Woodland, RD, CD, CDE

  • Registered Dietitian
  • Jefferson, WI
National Provider Identifier
1215297114
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1396-029 Issued in WI
Practice address
N4688 County Road Q
Jefferson, WI 53549-9556
Phone
(608) 295-6787
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2012

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 1396-029 WI Primary
Registered Dietitian 133V00000X 164.004903 IL

Addresses

Primary practice location

N4688 County Road Q
Jefferson, WI 53549-9556

Mailing address

N4688 County Road Q
Jefferson, WI 53549-9556
Phone (608) 295-6787

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
164.004903ILMDRegistered Dietitian
1396-029WIMDRegistered Dietitian
1396WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Nutrition LLC Past 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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1215297114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4688 COUNTY ROAD Q",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499556",
            "telephone_number": "608-295-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4688 COUNTY ROAD Q",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499556",
            "telephone_number": "608-295-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODLAND",
        "first_name": "KAREN",
        "middle_name": "ELAINA",
        "name_prefix": "Mrs.",
        "credential": "RD, CD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "1396-029",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.004903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.