Active NPI
Kimberly Jean Wegner, RD
- Registered Dietitian
- Nevada, MO
National Provider Identifier
1396960241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2004011232
- Practice address
- 800 S Ash St
Nevada, MO 64772-3223 - Phone
- (417) 667-3355
- Fax
- (417) 448-3796
- NPI assigned
- Apr 16, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 2004011232 | MO | Primary |
Addresses
Primary practice location
800 S Ash St
Nevada, MO 64772-3223
Mailing address
800 S Ash St
Nevada, MO 64772-3223
Phone (417) 667-3355
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2004011232 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396960241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S ASH ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723223",
"telephone_number": "417-667-3355",
"fax_number": "417-448-3796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S ASH ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723223",
"telephone_number": "417-667-3355",
"fax_number": "417-448-3796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGNER",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2004011232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nevada, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.