KELLY WIEBENGA RDN
NPI 1184412025
Dietitian, Registered in Sioux Falls, SD

Active since April 29, 2025
1211 S GRANGE AVE, SIOUX FALLS, SD 57105(605) 328-8500 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Wiebenga Rdn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY WIEBENGA RDN (NPI 1184412025) is an individual dietitian, registered in Sioux Falls, South Dakota, licensed in South Dakota (0856) and active in the NPI registry since April 2025. She is affiliated with Sanford Usd Medical Center and is a graduate of Other (1996).

NPPES Registry Identity

NPI1184412025
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameKELLY WIEBENGACredential: RDN
Location Address1211 S GRANGE AVESioux Falls, SD 57105-0402
Mailing AddressPo Box 5074Sioux Falls, SD 57117-5074 · (605) 328-9419
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateApril 29, 2025
Last NPPES UpdateMay 19, 2025
NPPES CertifiedMay 19, 2025
NPI 1184412025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License Licensed in SD · 0856
Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

1211 S GRANGE AVE, Sioux Falls, SD 57105

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kelly Wiebenga Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325550395
PECOS Enrollment IDI20250625001322

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Usd Medical Center

Acute Care Hospitals · Sioux Falls, SD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430027
Location1305 W 18th St Post Office Box 5039Sioux Falls, SD 57117 · Minnehaha County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
1211 S GRANGE AVE
SIOUX FALLS, SD 57105
Internal Medicine (Gastroenterology)
1211 S GRANGE AVE
SIOUX FALLS, SD 57105
Nurse Practitioner
1211 S GRANGE AVE
SIOUX FALLS, SD 57105

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Wiebenga's NPI number?

The NPI number for Kelly Wiebenga is 1184412025. It was assigned to this individual provider in the NPPES registry on April 29, 2025.

Where is Kelly Wiebenga located?

Kelly Wiebenga practices at 1211 S Grange Ave, Sioux Falls, SD 57105. The listed phone number is (605) 328-8500.

What is Kelly Wiebenga's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Kelly Wiebenga enrolled in Medicare?

Yes. Kelly Wiebenga is registered in the Medicare PECOS enrollment system.

What insurance does Kelly Wiebenga accept?

Health plans from Sanford Health Plan list Kelly Wiebenga as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Wiebenga affiliated with any hospitals?

According to CMS data, Kelly Wiebenga is affiliated with Sanford Usd Medical Center.

When was this NPI record last updated?

The NPPES record for Kelly Wiebenga was last updated on May 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.