Active NPI
Madeline Wellborn
- Registered Dietitian
- Denver, CO
National Provider Identifier
1407603178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86293321
- Practice address
- 1901 N Grant St Apt 425
Denver, CO 80203-1253 - Phone
- (318) 834-0158
- NPI assigned
- May 1, 2024
- 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 | 86293321 | CO | Primary |
Addresses
Primary practice location
1901 N Grant St Apt 425
Denver, CO 80203-1253
Mailing address
7 Onondaga St
Skaneateles, NY 13152-1313
Phone (315) 739-4459
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86293321 | CO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714521600000",
"number": "1407603178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ONONDAGA ST",
"city": "SKANEATELES",
"state": "NY",
"postal_code": "131521313",
"telephone_number": "315-739-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 N GRANT ST APT 425",
"city": "DENVER",
"state": "CO",
"postal_code": "802031253",
"telephone_number": "318-834-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLBORN",
"first_name": "MADELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-01",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "86293321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.