Active NPI
Elizabeth Wilson, RD
- Registered Dietitian
- Keosauqua, IA
National Provider Identifier
1811511587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86083551
- Practice address
- 304 Franklin St
Keosauqua, IA 52565-1164 - Phone
- (319) 293-3171
- Fax
- (319) 293-3174
- NPI assigned
- May 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86083551 | IA | Primary |
Addresses
Primary practice location
304 Franklin St
Keosauqua, IA 52565-1164
Mailing address
304 Franklin St
Keosauqua, IA 52565-1164
Phone (319) 293-3171
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86083551 | IA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1811511587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 FRANKLIN ST",
"city": "KEOSAUQUA",
"state": "IA",
"postal_code": "525651164",
"telephone_number": "319-293-3171",
"fax_number": "319-293-3174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 FRANKLIN ST",
"city": "KEOSAUQUA",
"state": "IA",
"postal_code": "525651164",
"telephone_number": "319-293-3171",
"fax_number": "319-293-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ELIZABETH",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-29",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "86083551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keosauqua, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.