Active NPI
Kelley Anastasia Wilson, MS, RD, CD, CNSC
- Registered Dietitian
- Madison, WI
National Provider Identifier
1295141109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2740-29
- Practice address
- 750 University Row
Room 353
Madison, WI 53705-1311 - Phone
- (608) 890-5005
- NPI assigned
- Jul 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2740-29 | WI | Primary |
Addresses
Primary practice location
750 University Row
Room 353
Madison, WI 53705-1311
Mailing address
750 University Row
Room 353
Madison, WI 53705-1311
Phone (608) 890-5005
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1295141109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 UNIVERSITY ROW",
"address_2": "ROOM 353",
"city": "MADISON",
"state": "WI",
"postal_code": "537051311",
"telephone_number": "608-890-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 UNIVERSITY ROW",
"address_2": "ROOM 353",
"city": "MADISON",
"state": "WI",
"postal_code": "537051311",
"telephone_number": "608-890-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KELLEY",
"middle_name": "ANASTASIA",
"credential": "MS, RD, CD, CNSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-11",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2740-29",
"primary": true
}
],
"identifiers": [],
"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 Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.