Gwendoline Balto, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2024046426 Issued in MO

Practice address

10525 Big Bend Rd
Saint Louis, MO 63122-6227

Phone

(314) 804-1848

Fax

(618) 209-1962

NPI assigned

Jan 13, 2025

Last updated

Jan 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Branz Nutrition Counseling

  • Registered Dietitian
  • O'Fallon, IL
  • NPI 1225785561

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1699585505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 BIG BEND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226227",
            "telephone_number": "312-590-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 BIG BEND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226227",
            "telephone_number": "314-804-1848",
            "fax_number": "618-209-1962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 Fortune Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Shiloh",
            "state": "IL",
            "postal_code": "622697385",
            "country_code": "US",
            "telephone_number": "314-804-1848",
            "fax_number": "618-209-1962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALTO",
        "first_name": "GWENDOLINE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2024046426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enisa Balogun
• Vasundhara Balraj
• Taylor Alexandra Balsman, PHARM. D.
• Michael George Baltes Jr., MD
• Mary Katherine Baltimore
• David T Balzer, MD
• Bam Urgent Care LLC (South County Urgent Care)
• Ahmed Khamis Bamaga, M.D, FRCPC,
• Sonya Bamba, MD
• Haley Hummer Bambini, PNP

• Registered Dietitian in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Registered Dietitian in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.