Individual provider Active NPI

Kaitlyn Marie Wengryniuk, MS, RD, LD

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1366844508
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1126 Salina St
Austin, TX 78702-2730
Phone
(216) 403-7937
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 7511 OH
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

1126 Salina St
Austin, TX 78702-2730

Mailing address

17329 Long Meadow TRL
Chagrin Falls, OH 44023-5617
Phone (216) 403-7937

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7511OHMDClinical Psychologist
2452SCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1366844508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17329 LONG MEADOW TRL",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440235617",
            "telephone_number": "216-403-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 SALINA ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787022730",
            "telephone_number": "216-403-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGRYNIUK",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "OH",
            "license": "7511",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.