Active NPI
Candace Winterbauer
- Registered Dietitian
- Creve Coeur, MO
National Provider Identifier
1871996967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2013034539
- Practice address
- 1020 N Mason Rd
Creve Coeur, MO 63141-6300 - Phone
- (314) 996-3140
- Fax
- (314) 996-3132
- NPI assigned
- Oct 2, 2014
- 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 | 2013034539 | MO | Primary |
Addresses
Primary practice location
1020 N Mason Rd
Creve Coeur, MO 63141-6300
Mailing address
1020 N Mason Rd
Creve Coeur, MO 63141-6300
Phone (314) 996-3140
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013034539 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1871996967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 N MASON RD",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416300",
"telephone_number": "314-996-3140",
"fax_number": "314-996-3132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 N MASON RD",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416300",
"telephone_number": "314-996-3140",
"fax_number": "314-996-3132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINTERBAUER",
"first_name": "CANDACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-02",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2013034539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.