Michelle Kerry Wagner, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

4210 Riverwalk Pkwy Ste 400
Riverside, CA 92505-3313

Phone

(951) 766-2444

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1932865524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9757 KEHL CANYON RD",
            "city": "CHERRY VALLEY",
            "state": "CA",
            "postal_code": "922233502",
            "telephone_number": "951-966-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 RIVERWALK PKWY STE 400",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053313",
            "telephone_number": "951-766-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MICHELLE",
        "middle_name": "KERRY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Darlene Wade
• Manvir Singh Wadhwa, MD
• Alexa Haydee Waggoner
• Margaret Waghorn, PTA (ASSOCIATES)
• Brandon M Wagner
• Susan Katali Wagner, PA-C
• Kenyada Marie Wagoner, LCSW
• Hakan Erik Wahlstrom, M.D.
• Alain A Waked, M.D.
• Lauren Angelique Wakoski

• Registered Dietitian in Riverside, CA
• Providers in Riverside, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.