Active NPI
Denise Michele Wagoner, CNS, LDN
- Obesity and Weight Management Nutrition Registered Dietitian
- Rehoboth Beach, DE
National Provider Identifier
1467317065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity and Weight Management Nutrition Registered Dietitian
- License
- DN-0010836
- Practice address
- 6 Tiffany Dr
Rehoboth Beach, DE 19971-9729 - Phone
- (302) 519-1840
- NPI assigned
- Dec 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | DN-0010836 | DE | |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | DN-0010836 | DE | Primary |
Addresses
Primary practice location
6 Tiffany Dr
Rehoboth Beach, DE 19971-9729
Mailing address
6 Tiffany Dr
Rehoboth Beach, DE 19971-9729
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
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN-0010836 | DE | MD | Nutrition Education Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765929600000",
"number": "1467317065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 TIFFANY DR",
"city": "REHOBOTH BEACH",
"state": "DE",
"postal_code": "199719729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 TIFFANY DR",
"city": "REHOBOTH BEACH",
"state": "DE",
"postal_code": "199719729",
"telephone_number": "302-519-1840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER",
"first_name": "DENISE",
"middle_name": "MICHELE",
"credential": "CNS, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-17",
"last_updated": "2025-12-17",
"certification_date": "2025-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "DE",
"license": "DN-0010836",
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "DE",
"license": "DN-0010836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rehoboth Beach, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.