Active NPI
Wonderfully Well LLC
- Registered Dietitian
- Gillette, WY
National Provider Identifier
1902439508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 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 DirectoryLocations
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.