Active NPI
Beth Lynne Wolfgram, RD
- Registered Dietitian
- Tucson, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, VA
Enrollment records 5
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1261 | NH | MD | Clinical Psychologist |
| 3168 | SC | MD | Chiropractor |
| DI613 | ME | MD | Sports Dietetics Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Woman Care, LLC | Current | Accepting new patients | |
| Genesis OB GYN PLLC | Current | Accepting new patients | |
| Mid-Atlantic Womens Care PLC | Current | Accepting new patients | |
| Uwh of the Carolinas, PLLC | Current | 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
- 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.
-
- Obstetrics & Gynecology Physician
- Tucson, AZ
- NPI 1992994214
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1386823243
-
- Obstetrics & Gynecology Physician
- Virginia Beach, VA
- NPI 1699365072
-
- Gynecology Physician
- Kirkland, WA
- NPI 1336888163
-
- Obstetrics & Gynecology Physician
- Novi, MI
- NPI 1083601082
-
- Obstetrics & Gynecology Physician
- Virginia Beach, VA
- NPI 1851339246
-
- Specialist
- Orlando, FL
- NPI 1366529042
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.