Individual provider Active NPI

Kerrie Sue Gamboni, REGISTERED DIETITIAN

  • Registered Dietitian
  • Webster, WI
National Provider Identifier
1831074285
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3320-29 Issued in WI
Practice address
2673 Gaslyn Creek Rd
Webster, WI 54893-8969
Phone
(715) 416-2529
NPI assigned
Aug 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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 3320-29 WI Primary

Addresses

Primary practice location

2673 Gaslyn Creek Rd
Webster, WI 54893-8969

Mailing address

2673 Gaslyn Creek Rd
Webster, WI 54893-8969
Phone (715) 416-2529

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
3320-29WIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1831074285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 GASLYN CREEK RD",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548938969",
            "telephone_number": "715-416-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2673 GASLYN CREEK RD",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548938969",
            "telephone_number": "715-416-2529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBONI",
        "first_name": "KERRIE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "3320-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.