Individual provider Active NPI

Dena Wiseman, RDN

  • Registered Dietitian
  • Mashpee, MA
National Provider Identifier
1972050029
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1178 Issued in MA
Practice address
107 Commercial St
Mashpee, MA 02649-6507
Phone
(508) 477-7090
Fax
(508) 477-7028
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1178 MA Primary

Addresses

Primary practice location

107 Commercial St
Mashpee, MA 02649-6507

Mailing address

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-7090

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

LicenseStateTypeSpecialty
1178MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Cape Cod, Inc. CurrentSince Dec 24, 2023 Accepting new patients
Community Health Center of Cape Cod Inc CurrentSince Dec 24, 2023 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

107 Commercial St
Mashpee, MA 02649
Phone (508) 539-6000

Organizations & group practices 3

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1972050029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "DENA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mashpee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.