Individual provider Active NPI

Jennifer Allen Wilson, RD

  • Renal Nutrition Registered Dietitian
  • Richmond, VA
National Provider Identifier
1710104336
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
Practice address
1250 E. Marshall Street
Clinical Nutrition
Richmond, VA 23298-0294
Phone
(804) 828-0970
Fax
(804) 628-0921
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X Primary
Registered Dietitian 133V00000X

Addresses

Primary practice location

1250 E. Marshall Street
Clinical Nutrition
Richmond, VA 23298-0294

Mailing address

PO Box 758997
Baltimore, MD 21275-0001
Phone (804) 828-2841

Other names 1

  • Miss Jennifer Louise Allen Former name

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1710104336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758997",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212750001",
            "telephone_number": "804-828-2841",
            "fax_number": "804-628-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E. MARSHALL STREET",
            "address_2": "CLINICAL NUTRITION",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980294",
            "telephone_number": "804-828-0970",
            "fax_number": "804-628-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "ALLEN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ALLEN",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.