Active NPI
Lindsay Wilson, RD
- Registered Dietitian
- Bloomington, IN
National Provider Identifier
1871005231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1014485
- Practice address
- 727 W 2ND St
Bloomington, IN 47403-2209 - Phone
- (812) 353-9258
- NPI assigned
- Oct 25, 2017
- 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 | 1014485 | IN | Primary |
Addresses
Primary practice location
727 W 2ND St
Bloomington, IN 47403-2209
Mailing address
5222 N Teresa LN
Bloomington, IN 47404-7602
Other practice location 1
2900 16th St
Bedford, IN 47421-3510
Phone (812) 277-3810
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 |
|---|---|---|---|
| 1014485 | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1871005231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5222 N TERESA LN",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474047602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 W 2ND ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032209",
"telephone_number": "812-353-9258"
}
],
"practiceLocations": [
{
"address_1": "2900 16th St",
"address_purpose": "LOCATION",
"city": "Bedford",
"state": "IN",
"postal_code": "474213510",
"country_code": "US",
"telephone_number": "812-277-3810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "LINDSAY",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "1014485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.