LISA A. WYCKOFF RD, CSR, LD – NPI #1396890273
Dietitian, Registered

An individual who is a Board Certified Specialist in Renal Nutrition and works directly with adult and/or pediatric patients with acute kidney injury, chronic kidney disease (CKD) stages 1-5, or receiving renal replacement therapies (dialysis/transplant) in a variety of settings, OR works indirectly in management, education, or research practice linked specifically to renal nutrition. The specialist in renal/nephrology nutrition is responsible for nutrition assessment, diagnosis, intervention, monitoring, and evaluation.

LISA WYCKOFF is a registered dietitian located in CRYSTAL RIVER, FL. NPPES has assigned the NPI number 1396890273 to LISA WYCKOFF on January 24, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. She is also known by her former name LISA ANNE BARTON. The primary taxonomy selected by this provider is 133VN1005X from the Health Care Provider Taxonomy code set, which is classified as Dietitian, Registered, specializing in Nutrition, Renal

The NPI profile was previously updated about 19 years ago on Jul 08, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LISA WYCKOFF below.

NPI Profile for
LISA A. WYCKOFF

NPI Number
1396890273
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
LISA A. WYCKOFF
Former Name: LISA ANNE BARTON
Credentials
RD, CSR, LD
Primary location
7415 W GULF TO LAKE HWY
CRYSTAL RIVER, FL 34429-7834
Phone: (352) 795-1415 Fax: (352) 564-0147
Mailing address
9 SHUMARD CT S
HOMOSASSA, FL 34446-4720
Phone: (352) 382-2048 Fax:
Sole Proprietor
Yes
Updated
Identifiers

Identifiers for LISA WYCKOFF

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE RAILROADFLP00025278
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
133VN1005X
- Dietitian, Registered / Nutrition, Renal (Primary)
FL ND2626

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.