Active NPI
Paige Prestigiacomo, RD
- Registered Dietitian
- Chaska, MN
National Provider Identifier
1861031254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4248
- Practice address
- 715 Weston Ridge Pkwy
Chaska, MN 55318-1202 - Phone
- (608) 692-2147
- NPI assigned
- Jan 2, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 4248 | MN | Primary |
Addresses
Primary practice location
715 Weston Ridge Pkwy
Chaska, MN 55318-1202
Mailing address
715 Weston Ridge Pkwy
Chaska, MN 55318-1202
Phone (608) 692-2147
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://gethealthie.com |
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 |
|---|---|---|---|
| 4248 | MN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley Management LLC | Dietitian, Registered | Past | Accepting new patients |
| Move to Wellness Inc | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1577923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577923200000",
"number": "1861031254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 WESTON RIDGE PKWY",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181202",
"telephone_number": "608-692-2147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 WESTON RIDGE PKWY",
"city": "CHASKA",
"state": "MN",
"postal_code": "553181202",
"telephone_number": "608-692-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESTIGIACOMO",
"first_name": "PAIGE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-02",
"last_updated": "2020-01-02",
"certification_date": "2020-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "4248",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://gethealthie.com",
"affiliation": "N",
"endpointDescription": "Telehealth",
"address_1": "715 Weston Ridge Pkwy",
"city": "Chaska",
"state": "MN",
"country_code": "US",
"postal_code": "553181202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chaska, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.