Individual provider Active NPI

Julie Dzik Anderson, RD

  • Registered Dietitian
  • Chaska, MN
National Provider Identifier
1619618055
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
14455 Issued in MN
Practice address
111 Hundertmark Rd
Chaska, MN 55318-4551
Phone
(952) 777-5778
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 14455 MN Primary

Addresses

Primary practice location

111 Hundertmark Rd
Chaska, MN 55318-4551

Mailing address

14345 Guthrie Ave
Apple Valley, MN 55124-6757
Phone (612) 437-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220520000815 MN Practitioner - Registered Dietitian Or Nutrition Professional 7911384508 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2580MNMDMarriage & Family Therapist
14455MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients
Ridgeview Medical Center CurrentSince Apr 11, 2022 Accepting new patients

Locations

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Chaska, MN 55318
Phone (952) 361-2447

111 Hundertmark Rd
Ste 115N
Chaska, MN 55318
Phone (952) 361-2450

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

560 S Maple St
Ste 400
Waconia, MN 55387
Phone (952) 442-3188

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, 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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1619618055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14345 GUTHRIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246757",
            "telephone_number": "612-437-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553184551",
            "telephone_number": "952-777-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JULIE",
        "middle_name": "DZIK",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "14455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.