Active NPI
Gaylyn Reske
- Registered Dietitian
- Wauwatosa, WI
National Provider Identifier
1891141149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2125-29
- Practice address
- 10935 W Wells St
Wauwatosa, WI 53226-3745 - Phone
- (414) 476-9199
- NPI assigned
- May 5, 2016
- Last updated
- May 5, 2016
- 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 | 2125-29 | WI | Primary |
Addresses
Primary practice location
10935 W Wells St
Wauwatosa, WI 53226-3745
Mailing address
10935 W Wells St
Wauwatosa, WI 53226
Phone (414) 476-9199
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 |
|---|---|---|---|
| 2125-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1891141149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10935 W WELLS ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "53226",
"telephone_number": "414-476-9199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10935 W WELLS ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532263745",
"telephone_number": "414-476-9199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESKE",
"first_name": "GAYLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-05",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2125-29",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.