Margaret B Prochaska, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

369292 Issued in WY

Practice address

831 Highway 150 S
Evanston, WY 82930-5340

Phone

(307) 789-3464

Fax

(307) 789-4592

NPI assigned

Dec 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• State of Wyoming

  dba Wyoming State Hospital

  • Psychiatric Hospital
  • Evanston, WY
  • NPI 1316011562
  NPD (past)

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1306175070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829310177",
            "telephone_number": "307-789-3464",
            "fax_number": "307-789-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 HIGHWAY 150 S",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305340",
            "telephone_number": "307-789-3464",
            "fax_number": "307-789-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "MARGARET",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WY",
            "license": "369292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN/BACHELOR OF SCIENCE & MASTER OF BASIC SCIENCE",
            "identifier": "369292",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Evanston, WY
• Providers in Evanston, WY by specialty
• Registered Dietitian in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.