Individual provider Active NPI

Marilyn C. Wadum, RD, LMNT

  • Nutritionist
  • Omaha, NE
National Provider Identifier
1619172913
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
183 Issued in NE
Practice address
8601 W Dodge Rd
Suite # 30
Omaha, NE 68114-3457
Phone
(402) 354-8797
Fax
(402) 354-5651
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 183 NE Primary
Registered Dietitian 133V00000X 183 NE

Addresses

Primary practice location

8601 W Dodge Rd
Suite # 30
Omaha, NE 68114-3457

Mailing address

5506 S 104TH Cir
Omaha, NE 68127-3036
Phone (402) 592-3610

Other identifiers 1

IdentifierTypeStateIssuer
183OtherNERD LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
183NEMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Past Accepting new patients
Nebraska Methodist Hospital Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619172913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 S 104TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681273036",
            "telephone_number": "402-592-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 W DODGE RD",
            "address_2": "SUITE # 30",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143457",
            "telephone_number": "402-354-8797",
            "fax_number": "402-354-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADUM",
        "first_name": "MARILYN",
        "middle_name": "C.",
        "credential": "RD, LMNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NE",
            "license": "183",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD LICENSE",
            "identifier": "183",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.