MS. CONNIE JEAN WILDT (NPI# 1356583504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356583504 |
| Entity Type | Individual |
| Full Name | MS. CONNIE JEAN WILDT |
| Credential | RD,LD |
| Practice Address |
615 S. New Ballas Rd St. Louis MO 63141-8221 |
| Mailing Address |
615 S. New Ballas Road St. John's Mercy Medical Center- Jfk Clinic St. Louis MO 63141-8277 |
| Practice Telephone | 3142514998 |
| Practice Fax Number | 3142517247 |
| Mailing Telephone | 3142514998 |
| Mailing Fax Number | 3142517247 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2009-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 2001024181 | MO | Dietary & Nutritional Service Providers |
| Street Address |
615 S. NEW BALLAS RD |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63141-8221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053359281 | Allison Grace Tuttle | Physician Assistant | 615 S. New Ballas Rd, Mercy Hospital St. Louis, St. Louis, MO 63141 | 2006-06-02 |
| 1912203118 | Matthew D Poeschl | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2011-02-04 |
| 1285945402 | Brian R. Odum | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2010-06-23 |
| 1114171915 | Ashima Agarwal | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2008-11-06 |
| 1528261146 | Inna Treskov | Student in an Organized Health Care Education/Training Program | 615 S. New Ballas Rd, Suite: 6006-b, St. Louis, MO 63141 | 2007-06-10 |
| 1154355261 | Julie E. Kunkel | Pathology | 615 S. New Ballas Rd, St. Louis, MO 63141 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| 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 |
|---|---|---|---|---|
| 1538715354 | Katharine M Rug | Dietitian, Registered | 1177 North Warson Rd, St. Louis, MO 63132 | 2019-08-16 |
| 1013400977 | Anne Henry Francis | Dietitian, Registered | Va St. Louis Health Care System, 1 Jefferson Barracks Drive, St. Louis, MO 63125 | 2018-06-14 |
| 1780114918 | Deborah Ann Zorensky | Dietitian, Registered | 7649 Delmar Blvd., The Center for Mind, Body & Spirit, St. Louis, MO 63130 | 2017-06-20 |
| 1669739488 | Katherine A Wolf | Dietitian, Registered | 1615 Fontana Drive, St. Louis, MO 63146 | 2012-04-18 |
| 1134315179 | Amber Joy Wamhoff | Dietitian, Registered | 470 Lake Avenue Unit 1 South, St. Louis, MO 63108 | 2007-09-24 |
| 1043327745 | Julia Ann Gilmer | Dietitian, Registered | 1 Jefferson Barracks Rd., 120/jb, St. Louis, MO 63125-4199 | 2006-08-25 |
| 1063434157 | Lindsey Allison Hooks | Dietitian, Registered | Des Peres Hospital, 2345 Dougherty Ferry Road, St. Louis, MO 63122-3313 | 2006-07-24 |
| 1184104515 | Cameron Earnheart | Dietitian, Registered | 3009 North Ballas Road, Building B - Suite 112, St. Louis, MO 63131 | 2018-08-15 |
| 1134462518 | Kristin Neusel | Dietitian, Registered | 10010 Kennerly Rd., St. Louis, MO 63128 | 2013-04-03 |
| 1497012389 | Jean Marie Brown | Dietitian, Registered | 12303 Depaul Drive, St. Louis, MO 63044-2588 | 2012-04-16 |
| Find all providers in ST. LOUIS | ||||
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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.