CAROLYN KELK (NPI# 1710467444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710467444 |
| Entity Type | Individual |
| Full Name | CAROLYN KELK |
| Credential | RD |
| Practice Address |
112 E 5th Ave Antigo WI 54409-2710 |
| Practice Telephone | 7156239873 |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | WI | Dietary & Nutritional Service Providers |
| Street Address |
112 E 5TH AVE |
| City | ANTIGO |
| State | WI |
| Zip Code | 54409-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568465201 | Stephen Larson | Nurse Anesthetist, Certified Registered | 112 E 5th Ave, Antigo, WI 54409-2710 | 2005-05-26 |
| 1295381481 | Melissa Flannery | Nurse Practitioner | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-08-13 |
| 1285295105 | Samantha Jean Stimac | Physical Therapist | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-06-21 |
| 1467016899 | Nikole Lynn Larkin | Nurse Practitioner | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-05-01 |
| 1487218400 | Rachael Elizabeth Miller | Physical Therapist | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-04-24 |
| 1366908790 | Hannah Elizabeth Wenzlick | Physician Assistant | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-02-11 |
| 1700359106 | Stephanie Krautkramer | Speech-Language Pathologist | 112 E 5th Ave, Antigo, WI 54409-2710 | 2019-01-08 |
| 1982181913 | Courtney Lynn Mattek | Nurse Practitioner | 112 E 5th Ave, Antigo, WI 54409-2710 | 2018-07-23 |
| 1922593805 | Dylan Michael Graff | Physician Assistant | 112 E 5th Ave, Antigo, WI 54409-2710 | 2018-06-25 |
| 1568911097 | Aaron Wright | Nurse Practitioner | 112 E 5th Ave, Antigo, WI 54409-2710 | 2016-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454036 | Jason Peter Cueny | Pharmacist | 200 E Highway 64, Antigo, WI 54409 | 2020-10-15 |
| 1770194524 | Christpher George Rowe | Technician | 825 Clermont S Apt 7, Antigo, WI 54409 | 2020-08-14 |
| 1033753512 | Joseph Gerger | Technician | 711 Badger Ave, Antigo, WI 54409 | 2019-10-29 |
| 1225368780 | Integrated Pain Solutions LLC | Clinic/Center | 2327 Neva Road, Antigo, WI 54409 | 2010-01-06 |
| 1558525212 | Jessica E Rosenberg | Social Worker | 310 South Superior Street, Antigo, WI 54409 | 2008-07-11 |
| 1053433292 | Raymond J Portman | Dentist | 705 Fifth Ave, Antigo, WI 54409 | 2007-04-06 |
| 1699801316 | Rick L Perkins | Obstetrics & Gynecology | Aspirus General Clinic, 110 East 5th Avenue, Antigo, WI 54409 | 2007-02-26 |
| 1205999646 | Earl J Roth | Chiropractor | 612 Century Ave, Antigo, WI 54409 | 2006-12-18 |
| 1811061187 | Rosanne Schermetzler | Occupational Therapist | 720 Ackley Street, Antigo, WI 54409 | 2006-11-20 |
| 1912084070 | Antigo Total Therapy & Sports Rehab Center Inc | Physical Therapist | 720 Askley Street, Antigo, WI 54409 | 2006-11-01 |
| Find all providers in zip 54409 | ||||
| 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 |
|---|---|---|---|---|
| 1033309315 | Kathleen M Bender | Dietitian, Registered | 110 E 5th Ave, Antigo, WI 54409-2710 | 2007-08-01 |
| 1023233822 | Bonnie J Hessedal | Dietitian, Registered | 110 E 5th Ave, Antigo, WI 54409-2710 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001909 | Wendy M Barth | Dietitian, Registered | N3035 Sidney Ave, Neillsville, WI 54456-7037 | 2020-10-21 |
| 1255946166 | Rachael Omdoll | Dietitian, Registered | 700 Airview Dr, Palmyra, WI 53156-9204 | 2020-09-09 |
| 1194336669 | Carly Duerst | Dietitian, Registered | W6068 Pioneer Rd, New Glarus, WI 53574-9735 | 2020-08-10 |
| 1730799636 | Bailey May Knutson | Dietitian, Registered | N44w6025 Hamilton Rd, Cedarburg, WI 53012-2454 | 2020-08-05 |
| 1538778550 | Kirsten White | Dietitian, Registered | W3021 Cara Way, Appleton, WI 54915-3991 | 2020-07-27 |
| 1780293696 | Samantha Jo Johnson | Dietitian, Registered | 2854 Greenbrier Rd, Green Bay, WI 54311-6528 | 2020-07-27 |
| 1487272977 | Sara Elizabeth Flitter | Dietitian, Registered | W437 Clement Cir, Campbellsport, WI 53010-1846 | 2020-07-10 |
| 1821616517 | Emily Anne Oschmann | Dietitian, Registered | 630 Woodland Cir, Waterford, WI 53185-2885 | 2020-07-08 |
| 1982221180 | Emilie Williamson | Dietitian, Registered | 1340 S 72nd St, West Allis, WI 53214-3122 | 2020-07-03 |
| 1811512916 | Nicole Lehtinen | Dietitian, Registered | 20200 Poplar Creek Pkwy Unit 116n, Brookfield, WI 53045-2163 | 2020-06-15 |
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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.