Kayla Maria Wilson, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86089156 Issued in NU

Practice address

475 Spring LN
Philadelphia, PA 19128-3918

Phone

(609) 638-1438

NPI assigned

Oct 12, 2021

Last updated

Oct 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Renfrew Centers, Inc.

  dba The Renfrew Center of Pennsylvania

  • Adult Mental Health Clinic/Center
  • Philadelphia, PA
  • NPI 1417971904
  NPD (past)

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1457013013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 SWETLAND DR",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189029082",
            "telephone_number": "609-638-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SPRING LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283918",
            "telephone_number": "609-638-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KAYLA",
        "middle_name": "MARIA",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN006388",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "86089156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Wilson
• Jennifer Wilson
• Jonathan Rashied Wilson Jr., ED.D.
• Joshua Wilson
• Julene Maryann Wilson, CRNP
• Kevin Wilson
• Khaiyana Wilson
• Kia Danielle Wilson, LPN
• Kim Marie Wilson, CRNP
• Lauren Wilson

• Registered Dietitian in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.