Active NPI
Donna J Sivertsen, RD, LDN, CDE
- Registered Dietitian
- Moline, IL
National Provider Identifier
1639397227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164003533
- Practice address
- 500 John Deere Rd
Moline, IL 61265-6892 - Phone
- (309) 779-5000
- NPI assigned
- Apr 22, 2007
- 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 | 164003533 | IL | Primary |
Addresses
Primary practice location
500 John Deere Rd
Moline, IL 61265-6892
Mailing address
2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-3200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164003533 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639397227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 17TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612015351",
"telephone_number": "309-779-3200",
"fax_number": "309-779-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 JOHN DEERE RD",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656892",
"telephone_number": "309-779-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIVERTSEN",
"first_name": "DONNA",
"middle_name": "J",
"credential": "RD, LDN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164003533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
- Param Puneet Singh, M.D.
- Annette Zoe Sirek Jones, MS, CCC-SLP
- Adiba Makhammatovna Sirojeva, APRN
- Phanicharan Aditya Sistla, M.D.
- Sisu Counseling Center, PLLC
- Veronica Skaradzinski, MS, RDN, LDN
- Kristine Skinner, BSW, MHP
- Jessica Slover Miller, LCPC, LMHC
- Elizabeth L Smith, LCSW
- Garvin B Smith III, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.