Active NPI
Alexandra Wilson
- Nutrition Education Nutritionist
- Denver, CO
National Provider Identifier
1679967772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- License
- 21110475
- Practice address
- 1400 Jackson St
Denver, CO 80206-2761 - Phone
- (303) 388-4461
- Fax
- (303) 270-2174
- NPI assigned
- Mar 26, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 21110475 | CO | Primary |
| Registered Dietitian | 133V00000X | 993180 | CO |
Addresses
Primary practice location
1400 Jackson St
Denver, CO 80206-2761
Mailing address
1400 Jackson St
Denver, CO 80206-2761
Phone (303) 388-4461
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21110475 | Other | CO | CERTIFIED DIABETES EDUCATOR |
| 993180 | Other | CO | REGISTERD DIETICIAN |
| 2008 | Other | CO | INTERNSHIP CERTIFICATE DIETETICS |
Other names 1
- Alexandra Munro
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 |
|---|---|---|---|
| 21110475 | CO | MD | Nutrition Education Nutritionist |
| 993180 | CO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427328000000",
"number": "1679967772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 JACKSON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802062761",
"telephone_number": "303-388-4461",
"fax_number": "303-270-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 JACKSON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802062761",
"telephone_number": "303-388-4461",
"fax_number": "303-270-2174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-26",
"last_updated": "2015-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "CO",
"license": "21110475",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "993180",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED DIABETES EDUCATOR",
"identifier": "21110475",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERD DIETICIAN",
"identifier": "993180",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNSHIP CERTIFICATE DIETETICS",
"identifier": "2008",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALEXANDRA",
"last_name": "MUNRO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.