MRS. LISA ANNE WYCKOFF (NPI# 1396890273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396890273 |
| Entity Type | Individual |
| Full Name | MRS. LISA ANNE WYCKOFF |
| Other Name | MISS LISA ANNE BARTON |
| Credential | RD, CSR, LD |
| Practice Address |
7415 W Gulf To Lake Hwy Crystal River FL 34429-7834 |
| Mailing Address |
9 Shumard Ct S Homosassa FL 34446-4720 |
| Practice Telephone | 3527951415 |
| Practice Fax Number | 3525640147 |
| Mailing Telephone | 3523822048 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1005X |
Dietitian, Registered Specialization: Nutrition, Renal |
ND2626 | FL | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE RAILROAD | P00025278 | 01 |
| Street Address |
7415 W GULF TO LAKE HWY |
| City | CRYSTAL RIVER |
| State | FL |
| Zip Code | 34429-7834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215029400 | Padma Venuaopala Reddy | Internal Medicine | 7415 W Gulf To Lake Hwy, Crystal River, FL 34429 | 2006-09-28 |
| 1528116027 | Citrus Nephrology Associates Inc | Internal Medicine | 7415 W Gulf To Lake Hwy, Crystal River, FL 34429-7834 | 2007-01-08 |
| 1245322106 | Sanjiv Ishverlal Shah | Internal Medicine | 7415 W Gulf To Lake Hwy, Crystal River, FL 34429-7834 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324386 | Sydney M Mergler | Specialist/Technologist | 315 Ne 10th St, Crystal River, FL 34429 | 2020-07-23 |
| 1497255814 | Plantation Medical Care, Pa | Clinic/Center | 9030 W Fort Island Trl Ste 11b, Crystal River, FL 34429 | 2018-02-13 |
| 1356864599 | Jeri Leigh Anderson | Family Medicine | 6199 W. Gulf To Lake Hwy, Crystal River, FL 34429 | 2017-07-19 |
| 1982011706 | Bambi Ann Heyer | Nurse Practitioner | 659 Ne Hwy 19 Unit 1, Crystal River, FL 34429 | 2014-07-14 |
| 1982977120 | Life Soulutions | Community/Behavioral Health | 427 Ne 3rd St Ste C, Crystal River, FL 34429 | 2012-02-20 |
| 1073844296 | Richard C Swanson,dmd Pa | Clinic/Center | 1815 Se Hwy 19, Crystal River, FL 34429 | 2010-01-28 |
| 1710116520 | Albert M. Boholst | Surgery | 730 S.e. 5th Terrace, Crystal River, FL 34429 | 2009-07-14 |
| 1033353453 | Claire Annette Wirt | Mechanotherapist | 1925 Se Hwy 19, Crystal River, FL 34429 | 2009-04-29 |
| 1811134067 | John D. Hosner, D.d.s., P.a. | Dentist | 1118 N. Suncoast Blvd., Crystal River, FL 34429 | 2009-01-09 |
| 1396981528 | Meadowcrest Family Physicians, P.a. | Family Medicine | 1250 N Vantage Pt Dr, Crystal River, FL 34429 | 2008-12-17 |
| Find all providers in zip 34429 | ||||
| Taxonomy Code | 133VN1005X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Renal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274104 | Mary Ellen Bing | Dietitian, Registered | 32 Iroquois Trl, Ormond Beach, FL 32174-4332 | 2020-08-07 |
| 1114545605 | Erika Marie Stahl | Dietitian, Registered | 651 Jamestown Blvd Apt 2116, Altamonte Springs, FL 32714-4683 | 2020-07-10 |
| 1659905016 | Erika Cook | Dietitian, Registered | 7 Sea Oaks Dr, St Augustine, FL 32080-7914 | 2020-02-25 |
| 1669039285 | Jennifer Mann | Dietitian, Registered | 1647 Island Way, Weston, FL 33326 | 2019-05-20 |
| 1306343850 | Annmarie Duggan | Dietitian, Registered | 18004 Nw 6th St Ste 104, Pembroke Pines, FL 33029-2823 | 2018-04-11 |
| 1245500933 | Jeanette Poillucci | Dietitian, Registered | 3700 Nw 88th Ave, 102, Sunrise, FL 33351-6556 | 2012-01-11 |
| 1710297452 | Susan Lynn Bottiglieri | Dietitian, Registered | 6641 Current Dr, Apollo Beach, FL 33572-1544 | 2010-10-15 |
| 1609189059 | John Dodd | Dietitian, Registered | 123 Sandcastle Dr, Ormond Beach, FL 32176-4156 | 2010-07-14 |
| 1548588627 | Cesiah Rojas | Dietitian, Registered | 11809 Sw 103rd Ln, Miami, FL 33186-8541 | 2010-05-13 |
| 1992020705 | Susan Marie Meese-morris | Dietitian, Registered | 333 Nw 70th Ave Ste 107, Plantation, FL 33317-2358 | 2010-04-05 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL RIVER |
| Zip Code | 34429 |
Please comment or provide details below to improve the information on MRS. LISA ANNE WYCKOFF.
| 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.