Active NPI
Tracy Nicole Gottschalk, REGISTERED DIETITIAN
- Registered Dietitian
- Montclair, NJ
National Provider Identifier
1851923189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 309 Orange Rd
Montclair, NJ 07042-4451 - Phone
- (908) 230-7648
- Fax
- (888) 649-4924
- NPI assigned
- Feb 5, 2020
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
309 Orange Rd
Montclair, NJ 07042-4451
Mailing address
49 Beverly Rd
Montclair, NJ 07043-2401
Phone (908) 230-7648
Other practice location 1
49 Beverly Rd
Montclair, NJ 07043-2401
Phone (908) 230-7648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86058451 | Other | COMMISSION ON DIETETIC REGISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gotcha Nutrition & Wellness LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
309 Orange Rd
Montclair, NJ 07042
Phone (908) 230-7648
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.
-
- Registered Dietitian
- Montclair, NJ
- NPI 1669251724
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733875200000",
"number": "1851923189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 BEVERLY RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070432401",
"telephone_number": "908-230-7648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 ORANGE RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070424451",
"telephone_number": "908-230-7648",
"fax_number": "888-649-4924"
}
],
"practiceLocations": [
{
"address_1": "49 Beverly Rd",
"address_purpose": "LOCATION",
"city": "Montclair",
"state": "NJ",
"postal_code": "070432401",
"country_code": "US",
"telephone_number": "908-230-7648",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOTTSCHALK",
"first_name": "TRACY",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-05",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "86058451",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.