Individual provider Active NPI

Crystal Wolfskill, RDN

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1790114874
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
892292 Issued in MO
Practice address
12023 Trampe Heights LN
Saint Louis, MO 63138-2659
Phone
(314) 438-9860
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 892292 MO Primary
Registered Dietitian 133V00000X 164005265 IL

Addresses

Primary practice location

12023 Trampe Heights LN
Saint Louis, MO 63138-2659

Mailing address

12023 Trampe Heights LN
Saint Louis, MO 63138-2659
Phone (314) 438-9860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
164005265ILMDRegistered Dietitian
892292MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1790114874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12023 TRAMPE HEIGHTS LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631382659",
            "telephone_number": "314-438-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12023 TRAMPE HEIGHTS LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631382659",
            "telephone_number": "314-438-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSKILL",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "892292",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.