Jennifer Anne Wilke, MS, RD, CED-S, CSSD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

12044801-4901 Issued in UT

Practice address

5373 S Green St Ste 400
Murray, UT 84123-4740

Phone

(801) 442-2615

NPI assigned

Nov 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Kaysville, UT
  • NPI 1154747087
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  NPD (past)

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1700188653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "435-901-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 S GREEN ST STE 400",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841234740",
            "telephone_number": "801-442-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKE",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "MS, RD, CED-S, CSSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2023-08-28",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "UT",
            "license": "12044801-4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J Wilde, MD
• Siena Wilder
• Brandon Wile
• Meadow Wiliams
• Shannon Wilk
• Christopher Gerald Wilkerson, M.D.
• Zackery Ross Wilkes, NP-C
• Craig West Wilkinson, M.D.
• James Michael Wilks, PT
• Megan M Williams Evans, OT

• Registered Dietitian in Murray, UT
• Providers in Murray, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.