Active NPI
Karen Elaina Woodland, RD, CD, CDE
- Registered Dietitian
- Jefferson, WI
National Provider Identifier
1215297114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1396-029
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.004903 | IL | MD | Registered Dietitian |
| 1396-029 | WI | MD | Registered Dietitian |
| 1396 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Health Service Clinic/Center
- Janesville, WI
- NPI 1437596517
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.