NPIMap

Organization Active NPI

Wotan Nutrition LLC

  • Registered Dietitian
  • Ann Arbor, MI
National Provider Identifier
1407455132
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
WOTAN NUTRITION LLC
Practice address
900 Patricia Ave
Ann Arbor, MI 48103-2634
Phone
(734) 263-7374
NPI assigned
Oct 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrea Wotan, RDNNPI 1760096523
Title
Owner
Phone
(734) 263-7374

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

900 Patricia Ave
Ann Arbor, MI 48103-2634

Mailing address

900 Patricia Ave
Ann Arbor, MI 48103-2634
Phone (734) 263-7374

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1407455132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PATRICIA AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032634",
            "telephone_number": "734-263-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PATRICIA AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032634",
            "telephone_number": "734-263-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOTAN NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "WOTAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-263-7374",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.