Active NPI
Kennette Monisa Wilsey, R.D., L.D.
- Registered Dietitian
- Edmond, OK
National Provider Identifier
1881863330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1033
- Practice address
- 17904 Haslemere LN
Edmond, OK 73012-4575 - Phone
- (405) 315-4877
- NPI assigned
- Feb 28, 2008
- 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 | 1033 | OK | Primary |
Addresses
Primary practice location
17904 Haslemere LN
Edmond, OK 73012-4575
Mailing address
17904 Haslemere LN
Edmond, OK 73012-4575
Phone (405) 359-4877
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 |
|---|---|---|---|
| 1033 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Medical Consultants, PLLC | Past | Accepting new patients |
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.
-
- General Practice Physician
- Dallas, TX
- NPI 1346839859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1881863330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17904 HASLEMERE LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730124575",
"telephone_number": "405-359-4877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17904 HASLEMERE LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730124575",
"telephone_number": "405-315-4877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSEY",
"first_name": "KENNETTE",
"middle_name": "MONISA",
"name_prefix": "Mrs.",
"credential": "R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.