Organization Active NPI

Wonderfully Well LLC

  • Registered Dietitian
  • Gillette, WY
National Provider Identifier
1902439508
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
WONDERFULLY WELL LLC
Practice address
2001 W Lakeway Rd Ste E
Gillette, WY 82718-5774
Phone
(307) 710-6790
NPI assigned
Feb 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Jamie Marchetti, MS, RDN, LD
Title
Dietitian/Owner
Phone
(307) 710-6790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

2001 W Lakeway Rd Ste E
Gillette, WY 82718-5774

Mailing address

PO Box 3944
Gillette, WY 82717-3944
Phone (307) 710-6790

National Provider Directory

National Provider Directory

Locations

2001 W Lakeway Rd
Ste E
Gillette, WY 82718
Phone (307) 710-6790

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1902439508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3944",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827173944",
            "telephone_number": "307-710-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W LAKEWAY RD STE E",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185774",
            "telephone_number": "307-710-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFULLY WELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "MARCHETTI",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "DIETITIAN/OWNER",
        "authorized_official_telephone_number": "307-710-6790",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.

Verify at the official NPI Registry.