Active NPI
Jenna Waite, RD
- Registered Dietitian
- Santa Clara, UT
National Provider Identifier
1184494155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 6578247-4901
- Practice address
- 2096 Rachel Dr
Santa Clara, UT 84765-5678 - Phone
- (435) 215-3299
- NPI assigned
- Jan 2, 2024
- Last updated
- Jan 2, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 6578247-4901 | UT | Primary |
Addresses
Primary practice location
2096 Rachel Dr
Santa Clara, UT 84765-5678
Mailing address
2096 Rachel Dr
Santa Clara, UT 84765-5678
Phone (435) 215-3299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6578247-4901 | Other | UT | STATE OF UTAH DEPARTMENT OF COMMERCE |
| 933202 | Other | COMMISION ON DIETETIC REGISTRATION (CDR) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6578247-4901 | UT | MD | Registered Dietitian |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1184494155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2096 RACHEL DR",
"city": "SANTA CLARA",
"state": "UT",
"postal_code": "847655678",
"telephone_number": "435-215-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2096 RACHEL DR",
"city": "SANTA CLARA",
"state": "UT",
"postal_code": "847655678",
"telephone_number": "435-215-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITE",
"first_name": "JENNA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-02",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "6578247-4901",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF UTAH DEPARTMENT OF COMMERCE",
"identifier": "6578247-4901",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISION ON DIETETIC REGISTRATION (CDR)",
"identifier": "933202",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Clara, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.