Active NPI
William Solomon Wonnenberg, LMNT, RD
- Registered Dietitian
- Rosebud, SD
National Provider Identifier
1356656581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 966
- Practice address
- 400 Soldier Creek Road
Rosebud, SD 57570-0400 - Phone
- (605) 747-2231
- Fax
- (605) 747-2216
- NPI assigned
- Aug 12, 2010
- Last updated
- Feb 18, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 966 | NE | |
| Registered Dietitian | 133V00000X | 966 | NE | Primary |
Addresses
Primary practice location
400 Soldier Creek Road
Rosebud, SD 57570-0400
Mailing address
PO Box 400
Rosebud, SD 57570-0400
Phone (605) 747-2231
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 |
|---|---|---|---|
| 966 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297987200000",
"number": "1356656581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 400",
"city": "ROSEBUD",
"state": "SD",
"postal_code": "575700400",
"telephone_number": "605-747-2231",
"fax_number": "605-747-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 SOLDIER CREEK ROAD",
"city": "ROSEBUD",
"state": "SD",
"postal_code": "575700400",
"telephone_number": "605-747-2231",
"fax_number": "605-747-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONNENBERG",
"first_name": "WILLIAM",
"middle_name": "SOLOMON",
"credential": "LMNT, RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-12",
"last_updated": "2011-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "NE",
"license": "966",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NE",
"license": "966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosebud, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.