Individual provider Active NPI

Beth Lynne Wolfgram, RD

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1760219281
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
655 E River Rd Unit 201
Tucson, AZ 85704-5853
Phone
(206) 895-4292
Fax
(833) 973-4034
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI613 ME
Registered Dietitian 133V00000X ND9159 FL
Registered Dietitian 133V00000X L006601 NC
Registered Dietitian 133V00000X 3168 SC
Registered Dietitian 133V00000X 1261 NH
Sports Dietetics Nutrition Registered Dietitian 133VN1501X DI613 ME
Registered Dietitian 133V00000X AZ Primary

Addresses

Primary practice location

655 E River Rd Unit 201
Tucson, AZ 85704-5853

Mailing address

PO Box 81064
Cleveland, OH 44181-0064
Phone (206) 895-4292

Other practice location 1

200 Perimeter Park Dr Ste C
Morrisville, NC 27560-9714
Phone (206) 895-4292

Other practice location 2

5323 4th Avenue Cir E
Bradenton, FL 34208-5623
Phone (206) 895-4292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ, NC, SC, VA5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20241017002448 FL Practitioner - Registered Dietitian Or Nutrition Professional 3577504307 Reassigns benefits to 1 organization
I20241121003107 AZ Practitioner - Registered Dietitian Or Nutrition Professional 3577504307 Reassigns benefits to 1 organization
I20241126004329 NC Practitioner - Registered Dietitian Or Nutrition Professional 3577504307 Reassigns benefits to 1 organization
I20250303001536 SC Practitioner - Registered Dietitian Or Nutrition Professional 3577504307 Reassigns benefits to 1 organization
I20250411000169 VA Practitioner - Registered Dietitian Or Nutrition Professional 3577504307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1261NHMDClinical Psychologist
3168SCMDChiropractor
DI613MEMDSports Dietetics Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC CurrentSince Nov 1, 2024 Accepting new patients
Genesis OB GYN PLLC CurrentSince Sep 18, 2024 Accepting new patients
Mid-Atlantic Womens Care PLC CurrentSince Jun 1, 2025 Accepting new patients
Uwh of the Carolinas, PLLC CurrentSince Sep 30, 2024 Accepting new patients
Metro Partners in Womens Health, PC Past Accepting new patients
Genneve Medical P.C. Past Accepting new patients
Mid-Atlantic Womens Care PLC Past Accepting new patients
Womencare PA Past Accepting new patients

Locations

1521 E Tangerine Rd
Ste 361
Oro Valley, AZ 85755
Phone (520) 545-0573

655 E River Rd
Unit 201
Tucson, AZ 85704
Phone (206) 895-4292

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

5323 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 745-5115

3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

200 Perimeter Park Dr
Ste C
Morrisville, NC 27560
Phone (206) 895-4292

1806 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 768-3632

1027 Physicians Dr
Ste 110
Charleston, SC 29414
Phone (843) 740-6700

844 Kempsville Rd
Ste 208
Norfolk, VA 23502
Phone (757) 461-3890

828 Healthy Way
Ste 330
Virginia Beach, VA 23462
Phone (206) 895-4292

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19050/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1760219281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81064",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441810064",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E RIVER RD UNIT 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045853",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Perimeter Park Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "NC",
            "postal_code": "275609714",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "fax_number": "833-450-5528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5323 4th Avenue Cir E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342085623",
            "country_code": "US",
            "telephone_number": "206-895-4292",
            "fax_number": "833-973-4033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFGRAM",
        "first_name": "BETH",
        "middle_name": "LYNNE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI613",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND9159",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L006601",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "3168",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NH",
            "license": "1261",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "ME",
            "license": "DI613",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.