Active NPI
Jenna Waters, MS, RD, LDN
- Registered Dietitian
- Knoxville, TN
National Provider Identifier
1336697390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LDN0000002384
- Practice address
- 1932 Alcoa Hwy
Knoxville, TN 37920-1527 - Phone
- (865) 971-3539
- NPI assigned
- Sep 19, 2016
- 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 | LDN0000002384 | TN | Primary |
Addresses
Primary practice location
1932 Alcoa Hwy
Knoxville, TN 37920-1527
Mailing address
PO Box 6765
Maryville, TN 37802-6765
Phone (865) 235-1777
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN0000002384 | TN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600300800000",
"number": "1336697390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6765",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378026765",
"telephone_number": "865-235-1777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1932 ALCOA HWY",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201527",
"telephone_number": "865-971-3539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "JENNA",
"credential": "MS, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-19",
"last_updated": "2020-09-17",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "LDN0000002384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.