Sierra Jacquelynn Wineinger, REGISTERED DIETITIAN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

LRD2062RD Issued in SC

Practice address

920 Doug White Dr Ste 420
Myrtle Beach, SC 29572-4182

Phone

(843) 353-5360

Fax

(843) 353-5363

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sierra Jacquelynn Mendenhall Former name

Medicare fee-for-service enrollment

Enrolled in SC, MO, IA3 enrollments

Enrollment records 3

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grand Strand Surgical Specialists LLCGroup PAC ID 4082770656, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Grand Strand Surgical Specialists, LLC

  • Surgery Physician
  • Myrtle Beach, SC
  • NPI 1841465804
  Medicare reassignment Care Compare group NPD
• SSM Cardinal Glennon Childrens Hospital

  • Pediatrics Physician
  • O Fallon, IL
  • NPI 1174577670

  MO

  Medicare reassignment NPD
• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD (past)
• SSM Cardinal Glennon Children'S Hospital

  • Pediatrics Physician
  • Warrenton, MO
  • NPI 1962573212
  NPD

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1770104283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 420",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724182",
            "telephone_number": "843-353-5360",
            "fax_number": "843-353-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DOUG WHITE DR STE 420",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724182",
            "telephone_number": "843-353-5360",
            "fax_number": "843-353-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEINGER",
        "first_name": "SIERRA",
        "middle_name": "JACQUELYNN",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "SC",
            "license": "LRD2062RD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIERRA",
            "last_name": "MENDENHALL",
            "middle_name": "JACQUELYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacquelyne Jones Wilson, MA, LPC
• Lisa Marie Wilson, PA
• Shaliah Deaisja Monteia Wilson
• Charlotte Wiltshire, RDN
• Rita Windes, LPN
• Shaylen Lane Wingert, DO
• Corinne Marie Wisdo, DPM
• Isabella Bernadette Wise, RN
• Mackenzie Ann Wisniewski
• Joan M Wiss, MD

• Pediatric Nutrition Registered Dietitian in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Pediatric Nutrition Registered Dietitian in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.