Active NPI
Jennifer Wax, R.D., L.D.
- Registered Dietitian
- Fort Myers, FL
National Provider Identifier
1902279979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND 7400
- Practice address
- 2727 Winkler Ave
Fort Myers, FL 33901-9358 - Phone
- (239) 424-2168
- NPI assigned
- Nov 12, 2015
- 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 | ND 7400 | FL | Primary |
Addresses
Primary practice location
2727 Winkler Ave
Fort Myers, FL 33901-9358
Mailing address
13300 Corbel Cir
Apt 2326
Fort Myers, FL 33907-6818
Phone (720) 810-5839
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND 7400 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1902279979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13300 CORBEL CIR",
"address_2": "APT 2326",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339076818",
"telephone_number": "720-810-5839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 WINKLER AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339019358",
"telephone_number": "239-424-2168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAX",
"first_name": "JENNIFER",
"credential": "R.D., L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-12",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND 7400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.