Laura R Wittke, MS RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

625808 Issued in AZ

Practice address

809 W Riordan Rd
Sutie 100 #327
Flagstaff, AZ 86001-0801

Phone

(928) 814-9585

NPI assigned

Mar 11, 2008

Last updated

Mar 11, 2008By 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)

Enrolled

Credentials

Master of Science

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.

• Practical Wellness LLC

  • Registered Dietitian
  • Atlanta, GA
  • NPI 1265718928

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1700056207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W RIORDAN RD",
            "address_2": "SUTIE 100 #327",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860010801",
            "telephone_number": "928-814-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W RIORDAN RD",
            "address_2": "SUTIE 100 #327",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860010801",
            "telephone_number": "928-814-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTKE",
        "first_name": "LAURA",
        "middle_name": "R",
        "credential": "MS RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "625808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Manalisay Wise, FNP RN
• Matthew Keith Wise, M.D.
• Lynn Spangenberg Wisniewski
• Rebecca Elaine Witt, R.N.
• James Michael Wittekind, P.T., D.P.T.
• Michaela Wixom
• Bret Bartholomew Wojciak, NMD
• Nicole J Wolf, PHD, LP
• Sandra Lynn Wolfe, D.C.
• Summer Wolfe, DNP, APRN, PMHNP-BC

• Registered Dietitian in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.