Individual provider Active NPI

Stephen Robert Seifert, RD,CD

  • Registered Dietitian
  • Manitowoc, WI
National Provider Identifier
1841834678
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3455-29 Issued in WI
Practice address
3415 Custer St
Manitowoc, WI 54220-4324
Phone
(920) 652-9310
Fax
(920) 652-9316
NPI assigned
Nov 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 3455-29 WI Primary

Addresses

Primary practice location

3415 Custer St
Manitowoc, WI 54220-4324

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

575 4th St
Kewaunee, WI 54216-1785
Phone (920) 388-4640

Other practice location 2

595 County Road R
Denmark, WI 54208-9120
Phone (920) 863-2005

Other practice location 3

831 Parker Ave
Algoma, WI 54201-1808
Phone (920) 487-3676

Other practice location 4

964 W Ryan St Ste B
Brillion, WI 54110-1077
Phone (920) 756-2055

Other identifiers 1

IdentifierTypeStateIssuer
86150257OtherCOMMISSION ON DIETETIC REGISTRATION

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Current Accepting new patients

Locations

831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084

595 R Rd
Denmark, WI 54208
Phone (920) 863-2005

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1841834678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 CUSTER ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204324",
            "telephone_number": "920-652-9310",
            "fax_number": "920-652-9316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 4th St",
            "address_purpose": "LOCATION",
            "city": "Kewaunee",
            "state": "WI",
            "postal_code": "542161785",
            "country_code": "US",
            "telephone_number": "920-388-4640",
            "fax_number": "920-388-0479",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "595 County Road R",
            "address_purpose": "LOCATION",
            "city": "Denmark",
            "state": "WI",
            "postal_code": "542089120",
            "country_code": "US",
            "telephone_number": "920-863-2005",
            "fax_number": "920-863-3508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "964 W Ryan St Ste B",
            "address_purpose": "LOCATION",
            "city": "Brillion",
            "state": "WI",
            "postal_code": "541101077",
            "country_code": "US",
            "telephone_number": "920-756-2055",
            "fax_number": "920-756-3350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEIFERT",
        "first_name": "STEPHEN",
        "middle_name": "ROBERT",
        "credential": "RD,CD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-05",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "3455-29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86150257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.