Active NPI
Cynthia Wilson, MS, CNS, LDN
- Nutrition Education Nutritionist
- Bowie, MD
National Provider Identifier
1023618600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- License
- DX5076
- Practice address
- 1812 Wetherbourne CT
Bowie, MD 20721-2772 - Phone
- (240) 484-3658
- NPI assigned
- Oct 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | DX5076 | MD | Primary |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | DX5076 | MD |
Addresses
Primary practice location
1812 Wetherbourne CT
Bowie, MD 20721-2772
Mailing address
1812 Wetherbourne CT
Bowie, MD 20721-2772
Phone (240) 484-3658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Specialist, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DX5076 | MD | MD | Obesity and Weight Management Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604102400000",
"number": "1023618600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 WETHERBOURNE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212772",
"telephone_number": "240-484-3658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 WETHERBOURNE CT",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212772",
"telephone_number": "240-484-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CYNTHIA",
"credential": "MS, CNS, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-31",
"last_updated": "2020-10-31",
"certification_date": "2020-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "MD",
"license": "DX5076",
"primary": true
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "MD",
"license": "DX5076",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.