JODY WAGNER (NPI# 1669860409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669860409 |
| Entity Type | Individual |
| Full Name | JODY WAGNER |
| Practice Address |
130 Division St Derby CT 06418-1326 |
| Practice Telephone | 8604788695 |
| Mailing Telephone | 8604788695 |
| Enumeration Date | 2015-01-01 |
| Last Update Date | 2015-01-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 001295 | CT | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699246421 | Jody Lynn Wagner | Speech-Language Pathologist | 204 Market Street, Denton, MD 21629 | 2018-12-05 |
| 1669971339 | Jody Wagner | Registered Nurse | 6400 Uptown Blvd Ne Ste 385, Albuquerque, NM 87110-4202 | 2018-02-07 |
| 1487656799 | Jody Michelle Wagner | Chiropractor | N110 Brux Rd, Appleton, WI 54915-9439 | 2005-06-01 |
| 1265573380 | Jody Wagner | Occupational Therapist | 50 W Schaumburg Rd, Schaumburg, IL 60194 | 2007-02-09 |
| Street Address |
130 DIVISION ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427058478 | Mihaela Boran | Psychiatry & Neurology | 130 Division St, Derby, CT 06418-1326 | 2005-07-29 |
| 1437767134 | Sovit Dahal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-07-20 |
| 1649894056 | Julie Sim | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-06-01 |
| 1073133435 | Angad Singh Gill | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2020-04-25 |
| 1699394924 | Ricardo Adolfo Concepcion Gomez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418 | 2020-04-16 |
| 1104455112 | Maharshi Panchal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-02 |
| 1104455252 | Anwesh Babu Poosala | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-01 |
| 1720615271 | Anthony Karam Awad | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-25 |
| 1134756760 | Douglas Misael Palacios Hernandez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
| 1437786142 | Rosa Constantino | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
| Find all providers in zip 06418 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962931337 | Carianne Palumbo | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2017-06-08 |
| 1477084069 | Lauren Karamavros | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2017-03-24 |
| 1225426448 | Kate Kelley | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2014-12-23 |
| 1003224221 | Stacey Leary | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2014-07-31 |
| 1912324815 | Melissa Mitri | Dietitian, Registered | 130 Division Street, Derby, CT 06418 | 2014-03-28 |
| 1952744500 | Larissa Zepko-march | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2013-04-14 |
| 1003070020 | Christina Ernst | Dietitian, Registered | 130 Division St, Derby, CT 06418-1326 | 2008-07-18 |
| 1346273224 | Kelly Lynnette Sheehan | Dietitian, Registered | 130 Division St, Dining Services, Derby, CT 06418-1326 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750882 | Lauren M Bush | Dietitian, Registered | 45 S Main St Ste 202, West Hartford, CT 06107-2402 | 2020-11-03 |
| 1528675972 | Kathryn Posillico | Dietitian, Registered | 29 Parker Ave, Stamford, CT 06906-1713 | 2020-09-29 |
| 1013524826 | Nicole Nyerick | Dietitian, Registered | 42 Willow Ct, Southington, CT 06489-3344 | 2020-09-25 |
| 1982211900 | Beth Saman | Dietitian, Registered | 150 Burwell Rd, New Hartford, CT 06057-4111 | 2020-09-24 |
| 1659985307 | Kathryn Balone | Dietitian, Registered | 23 Henry St Apt C, Greenwich, CT 06830-5809 | 2020-09-01 |
| 1952914301 | Louisa O'grady | Dietitian, Registered | 7 Beacon Hill Ter, Shelton, CT 06484-5905 | 2020-08-26 |
| 1245842228 | Hannah Yoo | Dietitian, Registered | 24 Old Farms Xing, Avon, CT 06001-2245 | 2020-08-20 |
| 1922619618 | Amy L Rapone | Dietitian, Registered | 67 Old Post Rd, Tolland, CT 06084-3342 | 2020-08-14 |
| 1700496361 | Cristina Gonzalez | Dietitian, Registered | 83 Morgan St Apt 5j, Stamford, CT 06905-5405 | 2020-08-07 |
| 1568071645 | Jillian Anastasia Wanik | Dietitian, Registered | 48 Sunnyledge St, New Britain, CT 06052-1604 | 2020-07-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.