Active NPI
Colleen Ann Wracker, RD,LD,CDE
- Metabolic Nutrition Registered Dietitian
- Columbia, SC
National Provider Identifier
1831528116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 339
- Practice address
- 6439 Garners Ferry Rd
Columbia, SC 29209-1638 - Phone
- (803) 776-4000
- NPI assigned
- Nov 6, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 339 | SC | Primary |
Addresses
Primary practice location
6439 Garners Ferry Rd
Columbia, SC 29209-1638
Mailing address
6439 Garners Ferry Rd
Columbia, SC 29209-1638
Phone (803) 776-4000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 339 | SC | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486339200000",
"number": "1831528116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6439 GARNERS FERRY RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292091638",
"telephone_number": "803-776-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6439 GARNERS FERRY RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292091638",
"telephone_number": "803-776-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRACKER",
"first_name": "COLLEEN",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RD,LD,CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-06",
"last_updated": "2017-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "SC",
"license": "339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.