Alexandra J Wynne, REGISTERED DIETICIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

5107 Medical Drive
San Antonio, TX 78229

Phone

(210) 614-8612

Fax

(210) 615-5596

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124136015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "ALEXANDRA",
        "middle_name": "J",
        "credential": "REGISTERED DIETICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Del Carmen Wynkoop, BCBA LBA
• Alexandra Wynn, MD
• Alison Wynn, LCSW
• James Michael Wynn, MD
• Kelsey Wynn, DPT
• Melissa Azeneth Wynne, LPC
• Susan K Wynne, MD
• Wyntequeon
• Chaznee R Wyrick, MS, CCC-SLP
• Linda Christine Wyrick, PH. D.

• Registered Dietitian in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.