Lisa Marie Wong, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD3989 Issued in OH

Practice address

648 Taylor Rd
Gahanna, OH 43230-3202

Phone

(614) 864-7225

Fax

(614) 626-8335

NPI assigned

Oct 6, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lisa Marie Hawk Other name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Ohio State University College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Nutrition Center IncGroup PAC ID 8426081357, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Ohio Nutrition Center, Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1528245685

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD
• Central Ohio Nutrition Center

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1083891147

  Dietitian, Registered

  NPD
• Central Ohio Nutrition Center, Inc

  • Family Medicine Physician
  • Gahanna, OH
  • NPI 1225197262

  Dietitian, Registered

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1881104610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 TAYLOR RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303202",
            "telephone_number": "614-864-7225",
            "fax_number": "614-626-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 TAYLOR RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303202",
            "telephone_number": "614-864-7225",
            "fax_number": "614-626-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD3989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HAWK",
            "middle_name": "MARIE",
            "credential": "RD, LD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erica Jean Winton, OTR/L, CHT
• David M Witter, MD
• Michael A. Wodarcyk, M.D.
• James Arthur Wolfe, OD
• Chloe A Wong, DMD
• Dawn R. Wright, OT/L
• Shawnequa Wright
• Larry Shuyue Wu, M.D.
• Raymond K. Wurapa, M.D.
• Emily Irene Wynkoop, MD

• Registered Dietitian in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.