Lisa Wakeman

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 805-1328

NPI assigned

Apr 7, 2022

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 names 1

• Lisa Hillstrom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1346982717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 N 62ND ST APT 209",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532133075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEMAN",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HILLSTROM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Waite, M.D.
• Kathryn Taylor Waitkus
• Caryn Elizabeth Wakefield, SLP
• Jaquaye Wakefield, PHD
• Martin K. Wakeham, MD
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2828)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3496)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2936)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2452)
• Wal-Mart Stores East, LP (Vision Center 30-2828)

• Registered Dietitian in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.