Active NPI
Sydney Wiseman
- Registered Dietitian
- Clearwater, FL
National Provider Identifier
1679324610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86341842
- Practice address
- 1813 Hammock Pine Blvd
Clearwater, FL 33761-4243 - Phone
- (813) 557-4685
- NPI assigned
- Mar 28, 2024
- Last updated
- Mar 28, 2024
- 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 | 86341842 | FL | Primary |
Addresses
Primary practice location
1813 Hammock Pine Blvd
Clearwater, FL 33761-4243
Mailing address
1813 Hammock Pine Blvd
Clearwater, FL 33761-4243
Phone (813) 557-4685
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 |
|---|---|---|---|
| 86341842 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Loft Services LLC | Dietitian, Registered | Past | Accepting new patients |
| Health Loft PLLC | Dietitian, Registered | 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, 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": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1679324610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1813 HAMMOCK PINE BLVD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337614243",
"telephone_number": "813-557-4685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1813 HAMMOCK PINE BLVD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337614243",
"telephone_number": "813-557-4685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISEMAN",
"first_name": "SYDNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-28",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "86341842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.