Individual provider Active NPI

Wahneta M Haywood, R.D., L.D

  • Registered Dietitian
  • Waverly, IA
National Provider Identifier
1447521067
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00150 Issued in IA
Practice address
312 9TH St SW
Waverly, IA 50677-2929
Phone
(319) 352-4120
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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 00150 IA Primary

Addresses

Primary practice location

312 9TH St SW
Waverly, IA 50677-2929

Mailing address

2722 Badger Ave
Janesville, IA 50647-9774
Phone (319) 987-2345

Other identifiers 2

IdentifierTypeStateIssuer
00150OtherIALICENSE, DIETETICS
401087OtherREGISTERED DIETITIAN

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
00150IAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1447521067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 BADGER AVE",
            "city": "JANESVILLE",
            "state": "IA",
            "postal_code": "506479774",
            "telephone_number": "319-987-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "WAHNETA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "00150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE, DIETETICS",
            "identifier": "00150",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "401087",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.