Active NPI
Emily Hope Kubisiak, RD
- Registered Dietitian
- Marinette, WI
National Provider Identifier
1972013985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3204-29
- Practice address
- 2820 Roosevelt Rd
Marinette, WI 54143-3834 - Phone
- (715) 735-5225
- Fax
- (175) 735-5388
- NPI assigned
- Oct 4, 2017
- 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 | 3204-29 | WI | Primary |
Addresses
Primary practice location
2820 Roosevelt Rd
Marinette, WI 54143-3834
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
704 S Webster Ave Ste 200
Green Bay, WI 54301-3531
Phone (920) 433-3456
Other practice location 2
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500
Other practice location 3
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700
Other practice location 4
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other practice location 5
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700
Other practice location 6
107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone (920) 846-3092
Other practice location 7
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 445-7222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86098663 | Other | COMMISSION ON DIETETIC REGISTRATION |
Other names 1
- Emily Hope Bauman
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3204-29 | WI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655078400000",
"number": "1972013985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 ROOSEVELT RD",
"city": "MARINETTE",
"state": "WI",
"postal_code": "541433834",
"telephone_number": "715-735-5225",
"fax_number": "175-735-5388"
}
],
"practiceLocations": [
{
"address_1": "704 S Webster Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013531",
"country_code": "US",
"telephone_number": "920-433-3456",
"fax_number": "920-433-3469",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-433-3500",
"fax_number": "920-445-7301",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3263 Eaton Rd",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543116830",
"country_code": "US",
"telephone_number": "920-433-6700",
"fax_number": "920-433-3719",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Arbutus Ave",
"address_purpose": "LOCATION",
"city": "Oconto",
"state": "WI",
"postal_code": "541532004",
"country_code": "US",
"telephone_number": "920-835-1100",
"fax_number": "920-835-1099",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1630 Commanche Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543135753",
"country_code": "US",
"telephone_number": "920-430-4700",
"fax_number": "920-430-4747",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "107 E Highland Dr",
"address_purpose": "LOCATION",
"city": "Oconto Falls",
"state": "WI",
"postal_code": "541541002",
"country_code": "US",
"telephone_number": "920-846-3092",
"fax_number": "920-846-8313",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "744 S Webster Ave",
"address_purpose": "LOCATION",
"city": "Green Bay",
"state": "WI",
"postal_code": "543013505",
"country_code": "US",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUBISIAK",
"first_name": "EMILY",
"middle_name": "HOPE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-04",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "3204-29",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "86098663",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "BAUMAN",
"middle_name": "HOPE",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Marinette, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.