TRACI BOLIN (NPI# 1164810016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164810016 |
| Entity Type | Individual |
| Full Name | TRACI BOLIN |
| Practice Address |
2020 N Tyler Rd Wichita KS 67212-4905 |
| Mailing Address |
14218 W Bluegrass Ct Wichita KS 67235-8065 |
| Practice Telephone | 3163126388 |
| Mailing Telephone | 3163126388 |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1966 | KS | Dietary & Nutritional Service Providers |
| Street Address |
2020 N TYLER RD |
| City | WICHITA |
| State | KS |
| Zip Code | 67212-4905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093164 | Andrew Jon Roy | Chiropractor | 2020 N Tyler Rd, Suite 112, Wichita, KS 67212-4905 | 2006-04-20 |
| 1467825729 | Perry Young | Physical Therapy Assistant | 2020 N Tyler Rd, Suite 112, Wichita, KS 67212-4905 | 2015-11-09 |
| 1366813909 | Michelle Drinnen | Occupational Therapist | 2020 N Tyler Rd, Suite 112, Wichita, KS 67212-4905 | 2015-10-08 |
| 1568839868 | Healthy Green Nutrition, LLC | Nutritionist | 2020 N Tyler Rd, Ste. 112, Wichita, KS 67212-4905 | 2015-08-22 |
| 1396142402 | Donna Robinson | Nurse Practitioner | 2020 N Tyler Rd, Suite 112, Wichita, KS 67212-4905 | 2014-12-04 |
| 1720322100 | Marti S Worman | Occupational Therapy Assistant | 2020 N Tyler Rd, Wichita, KS 67212-4905 | 2012-11-26 |
| 1992081939 | Key Rehabilitation, Inc | Occupational Therapist | 2020 N Tyler Rd, Wichita, KS 67212-4905 | 2011-10-21 |
| 1497929483 | Stephanie R Nicks | Nurse Practitioner | 2020 N Tyler Rd, Ste 112, Wichita, KS 67212-4905 | 2008-04-21 |
| 1912048125 | Anne Elizabeth Penner | Physician Assistant | 2020 N Tyler Rd, Suite 112, Wichita, KS 67212-4916 | 2007-02-09 |
| 1962593905 | Melanie Anne Greenwood | Family Medicine | 2020 N Tyler Rd, Ste 112, Wichita, KS 67212-4916 | 2006-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396974 | Kim Deann Kercher | Physical Therapist | Legacy At Grassland Estates, 10665 W 13th St N Apt 329, Wichita, KS 67212 | 2020-11-04 |
| 1700370954 | Andrea Lou Wheeler | Registered Nurse | 658 N Fairway Ave, Wichita, KS 67212 | 2018-06-20 |
| 1568981231 | Wichita Family Dental LLC | Dentist | 1445 N. Ridge Rd, Wichtia, KS 67212 | 2017-09-14 |
| 1396260121 | Keegan Hemberger | Pharmacist | 555 N. Maize Road, Wichita, KS 67212 | 2017-08-14 |
| 1154877603 | Alicia Rose Landrum | Counselor | 515 N Ridge Rd Ste 105, Wichita, KS 67212 | 2016-08-25 |
| 1306218920 | Brandee Young | Occupational Therapist | 9710 W. Jamesburg, Wichita, KS 67212 | 2015-10-22 |
| 1588072201 | Michelle Kuhn | Pharmacist | 10515 W Central, Wichita, KS 67212 | 2014-07-25 |
| 1972914083 | Linda Mueller Mueller | Marriage & Family Therapist | 4425 West Zoo Blvd, Wichita, KS 67212 | 2014-05-12 |
| 1619392305 | Jessica Smith | Counselor | 1319 W May, Wichita, KS 67212 | 2014-03-04 |
| 1245652064 | Keepsake Kottage, LLC | Custodial Care Facility | 8801 W Bekemeyer, Wichita, KS 67212 | 2014-01-14 |
| Find all providers in zip 67212 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114531944 | Ellen Marie Carp | Dietitian, Registered | 2728 N Hoover Rd, Wichita, KS 67205-1031 | 2020-08-31 |
| 1750991238 | Tyler Downs | Dietitian, Registered | 1542 N Mesa St, Wichita, KS 67212-1237 | 2020-08-09 |
| 1356960256 | Emily Lincicome | Dietitian, Registered | 1056 N Porter Ave, Wichita, KS 67203-3023 | 2020-04-10 |
| 1427681428 | Madison Osburn | Dietitian, Registered | 3450 N Rock Rd Ste 510, Wichita, KS 67226-1355 | 2020-02-18 |
| 1356868392 | Brianna Rae Sommers | Dietitian, Registered | 1660 N Tyler Rd Ste M, Wichita, KS 67212-4917 | 2017-08-29 |
| 1891184081 | Deborah Burchardt | Dietitian, Registered | 551 N Hillside St Ste 102, Wichita, KS 67214-4940 | 2015-01-12 |
| 1831595560 | Traci Bolin, Rdn, Ld LLC | Dietitian, Registered | 14218 W Bluegrass Ct, Wichita, KS 67235-8065 | 2014-11-06 |
| 1679904809 | Julia Bippert | Dietitian, Registered | 8110 E 32nd St N Ste 125, Wichita, KS 67226-2644 | 2013-12-13 |
| 1376553958 | Kyndra Elise Hamblin | Dietitian, Registered | 2349 S Milstead Ct, Wichita, KS 67209-3610 | 2006-08-08 |
| 1164488243 | Sandra L Martens | Dietitian, Registered | 7111 E 21st St N Ste A, Wichita, KS 67206 | 2006-04-26 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.