Stacy Hackenmueller, M.S., R.D., C.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI60317263 Issued in WA

Practice address

620 W 1St St
Wapato, WA 98951-1108

Phone

(509) 249-0477

Fax

(509) 877-6881

NPI assigned

Nov 27, 2012

Last updated

Aug 30, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Interoperability endpoints

• Direct secure messaging: shackenmueller10056@yvfwc.direct-ci.com

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1942545298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W 1ST ST",
            "city": "WAPATO",
            "state": "WA",
            "postal_code": "989511108",
            "telephone_number": "509-249-0477",
            "fax_number": "509-877-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W 1ST ST",
            "city": "WAPATO",
            "state": "WA",
            "postal_code": "989511108",
            "telephone_number": "509-249-0477",
            "fax_number": "509-877-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKENMUELLER",
        "first_name": "STACY",
        "credential": "M.S., R.D., C.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60317263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shackenmueller10056@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "620 W 1st St",
            "city": "Wapato",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989511108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jocelyne Isabelle Gaytan
• Roy E Gondo, M.D.
• Michael Howard Gravatt II, MD
• Rachel Gina Gregg, A.A. C.P.C.
• Erika Franco Gutierrez
• Roy Hernandez
• Katie Klingele, ATC
• Laboratory Corporation of America
• Nargis Mozafari
• Eric G. Nelson, DDS

• Registered Dietitian in Wapato, WA
• Providers in Wapato, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.