Active NPI
Bethany Waala, RDN, CD
- Registered Dietitian
- Pewaukee, WI
National Provider Identifier
1437045002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 086089384
- Practice address
- N23W25025 Valleyview LN
Pewaukee, WI 53072-4632 - Phone
- (920) 740-0611
- NPI assigned
- Jun 17, 2025
- Last updated
- Jun 17, 2025
- 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 | 086089384 | WI | Primary |
Addresses
Primary practice location
N23W25025 Valleyview LN
Pewaukee, WI 53072-4632
Mailing address
N23W25025 Valleyview LN
Pewaukee, WI 53072-4632
Phone (920) 740-0611
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 |
|---|---|---|---|
| 086089384 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1437045002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N23W25025 VALLEYVIEW LN",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530724632",
"telephone_number": "920-740-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N23W25025 VALLEYVIEW LN",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530724632",
"telephone_number": "920-740-0611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAALA",
"first_name": "BETHANY",
"credential": "RDN, CD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "086089384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.