Individual provider Active NPI

Jessica Price D'Argenio Waller, M.S., C.N.S., L.D.N.

  • Nutritionist
  • Baltimore, MD
National Provider Identifier
1306319223
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX4415 Issued in MD
Practice address
2000 Girard Ave
Baltimore, MD 21211-1595
Phone
(443) 328-4842
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DX4415 MD Primary

Addresses

Primary practice location

2000 Girard Ave
Baltimore, MD 21211-1595

Mailing address

8600 McDonogh Rd
Owings Mills, MD 21117-1009
Phone (410) 591-1297

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
DX4415MDMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1306319223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 MCDONOGH RD",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171009",
            "telephone_number": "410-591-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GIRARD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111595",
            "telephone_number": "443-328-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JESSICA",
        "middle_name": "PRICE D'ARGENIO",
        "credential": "M.S., C.N.S., L.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX4415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.