Caitlin Waddle, MS, RDN, LD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

LD004395 Issued in GA

Practice address

4045 Orchard Rd SE Ste 500
Smyrna, GA 30080-4900

Phone

(404) 654-3906

NPI assigned

Jun 19, 2015

Last updated

Jun 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Sprout Pediatric Nutrition LLC

  • Pediatric Nutrition Registered Dietitian
  • Smyrna, GA
  • NPI 1609550599

  Nutrition, Pediatric

  NPD Authorized official

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1205218872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 VILLAGE CREST DRIVE NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "502-648-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 ORCHARD RD SE STE 500",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804900",
            "telephone_number": "404-654-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDLE",
        "first_name": "CAITLIN",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "GA",
            "license": "LD004395",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "GA",
            "license": "LD004395",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GU",
            "license": "LD004395",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "GA",
            "license": "LD004395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatrice U Von Zeschau Wilder, MD
• VPG 1, LLC
• W. Theron McLarty MD PC
• Daphne M Wacasey, N.P.
• Rosemary Ann Wachtel, M.S.W.
• Anthony T. Wade, PA-C
• Kristen Lynn Wages, MSW
• Nobuhiro Wago
• Walgreen Co (Walgreens #05758)
• Walgreen Co (Walgreens #05901)

• Pediatric Nutrition Registered Dietitian in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Pediatric Nutrition Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.