Active NPI
Denise Roberts, MSRD
- Registered Dietitian
- Spooner, WI
National Provider Identifier
1972014751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1280 Chandler Dr
Spooner, WI 54801-2202 - Phone
- (715) 939-1690
- NPI assigned
- Oct 19, 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 | Primary |
Addresses
Primary practice location
1280 Chandler Dr
Spooner, WI 54801-2202
Mailing address
745 Pine PL
Rice Lake, WI 54868-2378
Phone (715) 651-2577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spooner Health System, Inc. | Current | Accepting new patients |
Locations
1280 Chandler Dr
Spooner, WI 54801
Phone (715) 635-2111
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1972014751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "745 PINE PL",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548682378",
"telephone_number": "715-651-2577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1280 CHANDLER DR",
"city": "SPOONER",
"state": "WI",
"postal_code": "548012202",
"telephone_number": "715-939-1690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "MSRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-19",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spooner, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.