Individual provider Active NPI

Denise Michele Wagoner, CNS, LDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Rehoboth Beach, DE
National Provider Identifier
1467317065
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
License
DN-0010836 Issued in DE
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

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN-0010836DEMDNutrition 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.

Verify at the official NPI Registry.