Tad Jacob Taggart, RD, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1710 Lawrence Dr Ste 200
De Pere, WI 54115-9195

Phone

(920) 570-6339

NPI assigned

Sep 8, 2021

Sex

Male

Sole proprietor

No

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 WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24776/brand/1/csg/1/fhir/r4

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment NPD
• Western Racquet & Fitness Club Inc

  • Registered Dietitian
  • Green Bay, WI
  • NPI 1316795214

  Dietitian, Registered

  NPD Authorized official
• Bellin Memorial Hospital

  • General Practice Physician
  • Green Bay, WI
  • NPI 1629260625
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Evolve LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1821541137
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1508535006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 LENWOOD AVE APT 7",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543035397",
            "telephone_number": "920-246-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 LAWRENCE DR STE 200",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159195",
            "telephone_number": "920-570-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGGART",
        "first_name": "TAD",
        "middle_name": "JACOB",
        "credential": "RD, CD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Sulewski, PHARMD
• Tina Sullivan, APSW
• Laurie L Sumnicht-Pieper, LPC
• Katherine Ann Szerkins, LCSW
• Katharine Page Tackaberry, MS, BCBA
• Andrea Q Taleon, MD
• TDR Inc
• Evan Teske, LAT, ATC
• Amos Thao, LPC
• The Att Center LTD

• Registered Dietitian in De Pere, WI
• Providers in De Pere, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.

Verify at the official NPI Registry.