Individual provider Active NPI

Madison Gaylor Wyatt, MS, RDN, LD

  • Registered Dietitian
  • Georgetown, TX
National Provider Identifier
1669351565
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86131082 Issued in TX
Practice address
536 Big Rocky BND
Georgetown, TX 78626-2638
Phone
(512) 797-5347
NPI assigned
Aug 27, 2025
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 86131082 TX Primary

Addresses

Primary practice location

536 Big Rocky BND
Georgetown, TX 78626-2638

Mailing address

536 Big Rocky BND
Georgetown, TX 78626-2638
Phone (512) 797-5347

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
Master of Science

State licenses

LicenseStateTypeSpecialty
86131082TXMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1669351565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 BIG ROCKY BND",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786262638",
            "telephone_number": "512-797-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 BIG ROCKY BND",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786262638",
            "telephone_number": "512-797-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MADISON",
        "middle_name": "GAYLOR",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86131082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.