Individual provider Active NPI

Jessica Witt, MS, CNS, LDN

  • Nutritionist
  • Columbia, MD
National Provider Identifier
1144958190
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX6954 Issued in MD
Practice address
11215 Avalanche Way
Unit B
Columbia, MD 21044
Phone
(240) 285-0224
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Nutrition Education Nutritionist 133NN1002X
Nutrition Education Nutritionist 133NN1002X DX6954 MD
Nutritionist 133N00000X DX6954 MD Primary

Addresses

Primary practice location

11215 Avalanche Way
Unit B
Columbia, MD 21044

Mailing address

11215 Avalanche Way
Unit B
Columbia, MD 21044
Phone (240) 285-0224

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

LicenseStateTypeSpecialty
DX6954MDMDNutrition Education Nutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Witt's End Nutrition Nutritionist CurrentSince Mar 11, 2025 Accepting new patients
Sagelight Integrative Wellness Center PastSince Aug 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1144958190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 AVALANCHE WAY",
            "address_2": "UNIT B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "240-285-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 AVALANCHE WAY",
            "address_2": "UNIT B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "240-285-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "JESSICA",
        "credential": "MS, CNS, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2025-06-27",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MD",
            "license": "DX6954",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX6954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.