Active NPI
Sharon Jean Butnick, M.S., R.D, C.D.
- Registered Dietitian
- Green Bay, WI
National Provider Identifier
1396041984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 512-29
- Practice address
- 141 Siegler St
Green Bay, WI 54303-2635 - Phone
- (920) 497-3126
- NPI assigned
- Jan 31, 2011
- Last updated
- Jan 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 512-29 | WI | Primary |
Addresses
Primary practice location
141 Siegler St
Green Bay, WI 54303-2635
Mailing address
141 Siegler St
Green Bay, WI 54303-2635
Phone (920) 497-3126
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 512-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1396041984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 SIEGLER ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543032635",
"telephone_number": "920-497-3126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 SIEGLER ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543032635",
"telephone_number": "920-497-3126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTNICK",
"first_name": "SHARON",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "M.S., R.D, C.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "512-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.