Individual provider Active NPI

Anna Wagner, RDN, LDN

  • Registered Dietitian
  • Carrboro, NC
National Provider Identifier
1356114284
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86253664 Issued in NC
Practice address
605 Jones Ferry Rd Apt KK5
Carrboro, NC 27510-2144
Phone
(919) 802-4798
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86253664 NC Primary

Addresses

Primary practice location

605 Jones Ferry Rd Apt KK5
Carrboro, NC 27510-2144

Mailing address

605 Jones Ferry Rd Apt KK5
Carrboro, NC 27510-2144
Phone (919) 802-4798

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

LicenseStateTypeSpecialty
86253664NCMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1356114284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 JONES FERRY RD APT KK5",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102144",
            "telephone_number": "919-802-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 JONES FERRY RD APT KK5",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102144",
            "telephone_number": "919-802-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ANNA",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "86253664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.