Brooke Dipoma Bouwhuis, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

865063 Issued in UT

Practice address

958 Doris PL
Kaysville, UT 84037-6830

Phone

(801) 628-8543

NPI assigned

Dec 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  Medicare reassignment Care Compare group NPD
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Tanner Memorial Clinic

  • Gastroenterology Physician
  • Ogden, UT
  • NPI 1609406511
  NPD

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1457063034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 DORIS PL",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840376830",
            "telephone_number": "801-628-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 DORIS PL",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840376830",
            "telephone_number": "801-628-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUWHUIS",
        "first_name": "BROOKE",
        "middle_name": "DIPOMA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "865063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliana K Betker, RDN, CD
• Nancy Meiyun-Chiu Bivens, M.D., PH.D.
• Kami Black
• Blair Dantz Blonquist, LCSW
• Mallorie Borup, LCSW
• Bowman Inc
• Trisha Sisson Brimhall, RDN
• Phillip Marshall Brough, MD
• Jenny Brower
• Hayley Brown

• Registered Dietitian in Kaysville, UT
• Providers in Kaysville, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.