Active NPI
Kira Wilson, RD
- Registered Dietitian
- Portage, WI
National Provider Identifier
1396935987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 850777
- Practice address
- 2817 New Pinery Rd
Portage, WI 53901-9240 - Phone
- (608) 742-4131
- NPI assigned
- Jul 30, 2007
- 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 | 850777 | WI | Primary |
Addresses
Primary practice location
2817 New Pinery Rd
Portage, WI 53901-9240
Mailing address
882 McMillan Rd
Poynette, WI 53955-9227
Phone (608) 265-0963
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 850777 | WI | MD | Registered Dietitian |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Houston, TX
- NPI 1033157821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1396935987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "882 MCMILLAN RD",
"city": "POYNETTE",
"state": "WI",
"postal_code": "539559227",
"telephone_number": "608-265-0963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 NEW PINERY RD",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539019240",
"telephone_number": "608-742-4131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KIRA",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-30",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "850777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.