Active NPI
Alyse C Wagner, RD
- Registered Dietitian
- New Albany, IN
National Provider Identifier
1801309489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 37002830A
- Practice address
- 2125 State St Ste 1
New Albany, IN 47150-4987 - Phone
- (812) 949-7151
- Fax
- (812) 949-7191
- NPI assigned
- Nov 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 37002830A | IN | Primary |
Addresses
Primary practice location
2125 State St Ste 1
New Albany, IN 47150-4987
Mailing address
2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (812) 273-5392
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": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509926400000",
"number": "1801309489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 STANLEY GAULT PKWY STE 129",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402235176",
"telephone_number": "812-273-5392",
"fax_number": "812-489-5750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 STATE ST STE 1",
"city": "NEW ALBANY",
"state": "IN",
"postal_code": "471504987",
"telephone_number": "812-949-7151",
"fax_number": "812-949-7191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "ALYSE",
"middle_name": "C",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-06",
"last_updated": "2017-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "37002830A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Albany, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.