Active NPI
Callie Hicks, RD
- Registered Dietitian
- West Bend, WI
National Provider Identifier
1376941641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2742
- Practice address
- 1700 Paradise Dr
West Bend, WI 53095-9000 - Phone
- (262) 334-3451
- NPI assigned
- Dec 18, 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 | 2742 | WI | Primary |
Addresses
Primary practice location
1700 Paradise Dr
West Bend, WI 53095-9000
Mailing address
1700 Paradise Dr
West Bend, WI 53095-9000
Phone (262) 334-3451
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1376941641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 PARADISE DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959000",
"telephone_number": "262-334-3451",
"fax_number": "262-334-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 PARADISE DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959000",
"telephone_number": "262-334-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "CALLIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-18",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.