Active NPI
Rachel Grace Renee Willis, RDN, LD
- Registered Dietitian
- Wyoming, MI
National Provider Identifier
1891248985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 10362
- Practice address
- 5838 Metro Way SW
Wyoming, MI 49519-9619 - Phone
- (616) 249-5300
- Fax
- (616) 249-5341
- NPI assigned
- Jul 26, 2016
- 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 | 10362 | OH | Primary |
Addresses
Primary practice location
5838 Metro Way SW
Wyoming, MI 49519-9619
Mailing address
2076 Brookbank Dr
Grove City, OH 43123-4733
Phone (269) 601-1186
Other names 1
- Mrs. Rachel Grace Renee Mather
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 |
|---|---|---|---|
| 10362 | OH | MD | Oncology Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whole Health Consultants LLC | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Battle Creek Vamc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Registered Dietitian
- Grove City, OH
- NPI 1922827971
Dietitian, Registered
-
- Department of Veterans Affairs (VA) Pharmacy
- Wyoming, MI
- NPI 1881642858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1891248985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2076 BROOKBANK DR",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431234733",
"telephone_number": "269-601-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5838 METRO WAY SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199619",
"telephone_number": "616-249-5300",
"fax_number": "616-249-5341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "RACHEL",
"middle_name": "GRACE RENEE",
"name_prefix": "Mrs.",
"credential": "RDN, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "10362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "MATHER",
"middle_name": "GRACE RENEE",
"prefix": "MRS.",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.