Rebecca Crumb-Johnson, RD
Individual provider Active NPI Registered Dietitian · Ashland, WI
NPI 1982879532 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1982879532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 1090-029 (WI)
- Practice address
- 1615 Maple LN
Ashland, WI 54806-3610 - Phone
- (715) 685-5463
- Fax
- (715) 685-5154
- NPI assigned
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Lakes Community Health Center Inc
Practice addresses (Care Compare)
7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210713000826 | WI | Practitioner - Registered Dietitian Or Nutrition Professional | 7012318298 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1090-029 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Lakes Community Health Center, Inc | Current |
Accepting new patients | |
| The Lakes Community Health Center, Inc | Current |
Accepting new patients | |
| The Lakes Community Health Center, Inc | Past | Accepting new patients |
Locations
1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563
300 Main St W
Ashland, WI 54806
Phone (715) 685-2200
15954 Rivers Edge Dr
Hayward, WI 54843
15735 W US Highway 63
Hayward, WI 54843
7665 US Highway 2
Iron River, WI 54847
Phone (715) 372-5001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1090-029 | WI | Yes |
Addresses
Primary practice location
1615 Maple LN
Ashland, WI 54806-3610
Mailing address
1615 Maple LN
Ashland, WI 54806-3610
Phone (715) 685-5463
Other providers in Ashland, WI
- Cooperative Educational Service Agency #12
- County of Ashland
- Dana Jacqueline Covey
- Cpi Ashland, LLC
- Cpi Ashland, LLC
- Kelli Danielle Culver
- Justin Shawn Cummins
- Katie M Cunningham
- Thomas C. Cunningham
- Stephen Charles Cushing
All providers in Ashland, WI · Registered Dietitian in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.