Active NPI
Zachary Tyler Wenger
- Registered Dietitian
- State College, PA
National Provider Identifier
1104797281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 215 Fernwood CT
State College, PA 16803-1659 - Phone
- (703) 618-4221
- NPI assigned
- Sep 13, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
215 Fernwood CT
State College, PA 16803-1659
Mailing address
215 Fernwood CT
State College, PA 16803-1659
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757721600000",
"number": "1104797281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 FERNWOOD CT",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168031659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 FERNWOOD CT",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168031659",
"telephone_number": "703-618-4221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENGER",
"first_name": "ZACHARY",
"middle_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-13",
"last_updated": "2025-09-13",
"certification_date": "2025-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.