Individual provider Active NPI

Sarah M Wills I, RD,LD

  • Registered Dietitian
  • Fosston, MN
National Provider Identifier
1841967213
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4539 Issued in MN
Practice address
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone
(218) 435-1133
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 1306 ND
Registered Dietitian 133V00000X 4539 MN Primary

Addresses

Primary practice location

900 Hilligoss Blvd SE
Fosston, MN 56542-1542

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927002131 MN Practitioner - Registered Dietitian Or Nutrition Professional 1153728670 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4539MNMDMarriage & Family Therapist
1306NDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Regional Health Center CurrentSince Sep 20, 2021 Accepting new patients
St Mary'S Regional Health Center CurrentSince Sep 20, 2021 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
First Care Medical Services CurrentSince Sep 20, 2021 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

705 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-2800

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

Organizations & group practices 4

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1841967213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HILLIGOSS BLVD SE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421542",
            "telephone_number": "218-435-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "SARAH",
        "middle_name": "M",
        "name_suffix": "I",
        "credential": "RD,LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "1306",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fosston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.