Nicholle Karen Super, RD, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2412-29 Issued in WI

Practice address

2321 Stout Rd
Menomonie, WI 54751-7003

Phone

(715) 235-5531

NPI assigned

Nov 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicholle Karen Birdsill Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: noman22690@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System-Menomonie

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System in Eau Claire

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System-Bloomer

  • Multi-Specialty Clinic/Center
  • Bloomer, WI
  • NPI 1548796444
  NPD

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1932486024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 STOUT RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547517003",
            "telephone_number": "715-235-5531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "S2845 White Eagle Rd",
            "address_purpose": "LOCATION",
            "city": "Baraboo",
            "state": "WI",
            "postal_code": "539139064",
            "country_code": "US",
            "telephone_number": "888-552-7889 x5554",
            "fax_number": "608-356-7152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPER",
        "first_name": "NICHOLLE",
        "middle_name": "KAREN",
        "credential": "RD, CD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2412-29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "noman22690@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2321 Stout Rd",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547517003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLLE",
            "last_name": "BIRDSILL",
            "middle_name": "KAREN",
            "credential": "RD, CD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Stogdill
• Ashley Strenke, PHARMD
• Jennifer A Strong, MD
• Stucky Chiropractic Menomonie S.C.
• Hayley Suckow
• Shawn W Swaenepoel, D.O.
• Heidi Swartz
• Cara N. Syth, M.D.
• Melinda Joy Szemraj
• Marissa Talmage, PA-C

• Registered Dietitian in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.