Individual provider Active NPI

Michaela Rausch, RDN, LDN

  • Registered Dietitian
  • Wadena, MN
National Provider Identifier
1740912559
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86103862 Issued in MN
Practice address
415 Jefferson St N
Wadena, MN 56482-1264
Phone
(218) 632-7188
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86103862 MN Primary

Addresses

Primary practice location

415 Jefferson St N
Wadena, MN 56482-1264

Mailing address

415 Jefferson St N
Wadena, MN 56482-1264

Other names 1

  • Michaela Koenig Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240309000670 MN Practitioner - Registered Dietitian Or Nutrition Professional 8527404771 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86103862MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health CurrentSince Jan 6, 2024 Accepting new patients
Astera Health Current Accepting new patients
Astera Health CurrentSince Jan 6, 2024 Accepting new patients

Locations

421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Organizations & group practices 3

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1740912559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 JEFFERSON ST N",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821264",
            "telephone_number": "218-632-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUSCH",
        "first_name": "MICHAELA",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "86103862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAELA",
            "last_name": "KOENIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wadena, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.