Active NPI
Madelyn Elaine Valentine, RDN
- Registered Dietitian
- Shawano, WI
National Provider Identifier
1598307407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86107934
- Practice address
- 311 N Main St
Shawano, WI 54166-2145 - Phone
- (715) 526-2822
- NPI assigned
- Oct 11, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 86107934 | WI | Primary |
Addresses
Primary practice location
311 N Main St
Shawano, WI 54166-2145
Mailing address
2088 Memorial Dr Apt 110
Green Bay, WI 54303-5302
Phone (920) 676-9513
Other practice location 1
2088 Memorial Dr Apt 110
Green Bay, WI 54303-5302
Phone (920) 676-9513
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 |
|---|---|---|---|
| 86107934 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570752000000",
"number": "1598307407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2088 MEMORIAL DR APT 110",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543035302",
"telephone_number": "920-676-9513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 N MAIN ST",
"city": "SHAWANO",
"state": "WI",
"postal_code": "541662145",
"telephone_number": "715-526-2822"
}
],
"practiceLocations": [
{
"address_1": "2088 Memorial Dr Apt 110",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543035302",
"country_code": "US",
"telephone_number": "920-676-9513",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VALENTINE",
"first_name": "MADELYN",
"middle_name": "ELAINE",
"name_prefix": "Miss",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-11",
"last_updated": "2019-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "86107934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawano, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.