Individual provider Active NPI

Jessica Ann Wegener, RD

  • Registered Dietitian
  • Omaha, NE
National Provider Identifier
1467684092
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
720 Issued in NE
Practice address
13809 Industrial Rd
Omaha, NE 68137-1117
Phone
(480) 208-0418
NPI assigned
Aug 15, 2009
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Registered Dietitian 133V00000X 720 NE Primary

Addresses

Primary practice location

13809 Industrial Rd
Omaha, NE 68137-1117

Mailing address

23514 Lakeview St
Elkhorn, NE 68022-4381
Phone (402) 669-2705

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
720NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Nutrition of Omaha LLC Dietitian, Registered CurrentSince Sep 8, 2024 Accepting new patients

Locations

11414 W Center Rd
Ste 321
Omaha, NE 68144
Phone (402) 669-2705

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1250294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1467684092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23514 LAKEVIEW ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224381",
            "telephone_number": "402-669-2705",
            "fax_number": "402-932-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13809 INDUSTRIAL RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371117",
            "telephone_number": "480-208-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGENER",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-15",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.