Individual provider Active NPI

Joanna Wolverton, RD, CDCES

  • Registered Dietitian
  • Klamath Falls, OR
National Provider Identifier
1659988293
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-10160301 Issued in OR
Practice address
2630 Campus Dr
Klamath Falls, OR 97601-1105
Phone
(541) 274-2633
Fax
(541) 274-2005
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 LD-D-10160301 OR Primary

Addresses

Primary practice location

2630 Campus Dr
Klamath Falls, OR 97601-1105

Mailing address

2630 Campus Dr
Klamath Falls, OR 97601-1105
Phone (541) 274-2633

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

LicenseStateTypeSpecialty
LD-D-10160301ORMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1659988293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 CAMPUS DR",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011105",
            "telephone_number": "541-274-2633",
            "fax_number": "541-274-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 CAMPUS DR",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011105",
            "telephone_number": "541-274-2633",
            "fax_number": "541-274-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLVERTON",
        "first_name": "JOANNA",
        "name_prefix": "Ms.",
        "credential": "RD, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10160301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.