Individual provider Active NPI

Ashley Diane Willson, RD, CDN, CCDES

  • Registered Dietitian
  • Halfmoon, NY
National Provider Identifier
1679843643
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
007330-1 Issued in NY
Practice address
1783 Route 9 Ste 101
Halfmoon, NY 12065-2467
Phone
(518) 881-1091
Fax
(518) 881-0796
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 007330 NY
Registered Dietitian 133V00000X 007330-1 NY Primary

Addresses

Primary practice location

1783 Route 9 Ste 101
Halfmoon, NY 12065-2467

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other names 1

  • Ashley Diane Wojcicki Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200422001276 NY Practitioner - Registered Dietitian Or Nutrition Professional 0547690117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLC 361 clinicians

Practice addresses (Care Compare)

1783 Route 9
Suite 101
Halfmoon, NY 12065-2467
Phone (518) 371-5437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007330-1NYMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Apr 20, 2025 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Saratoga Hospital Past Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

84 E State St
Gloversville, NY 12078
Phone (518) 332-4336

1783 Route 9
Ste 101
Halfmoon, NY 12065
Phone (518) 881-1091

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

Interoperability endpoints

  • Direct secure messaging: ashleywillson@ccp.allscriptsdirect.net

Organizations & group practices 5

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1679843643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 ROUTE 9 STE 101",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652467",
            "telephone_number": "518-881-1091",
            "fax_number": "518-881-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "ASHLEY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "RD, CDN, CCDES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "007330",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "007330-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WOJCICKI",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.