Jacqueline E Wyman, MS, RD, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

3 Orchard Dr
Purchase, NY 10577-2205

Phone

(917) 797-7809

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline E Wyman Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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

• Nutrition in Motion

  • Registered Dietitian
  • Bedford, NH
  • NPI 1548437312

  Dietitian, Registered, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1699432401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ORCHARD DR",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772205",
            "telephone_number": "917-797-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ORCHARD DR",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772205",
            "telephone_number": "917-797-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "credential": "MS, RD, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WYMAN",
            "middle_name": "E",
            "credential": "MS, RD, CDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steven Ray Wilkening, MD, MS
• Gazaria C Williams, LMHC CABA
• Dembe Wilson
• Katherine Estelle Wolff, PT
• Carol Lynn Wurzel, MD
• Irene Yu, MD
• Linda Yue, M.D.
• Jan Zislis, M.D.
• Dara Maxine Zweiman

• Registered Dietitian in Purchase, NY
• Providers in Purchase, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.