KELLY WAGNER (NPI# 1295288629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295288629 |
| Entity Type | Individual |
| Full Name | KELLY WAGNER |
| Credential | MS, RD, LD |
| Practice Address |
200 Hawkins Dr Food and Nutrition Services, W146 Gh Iowa City IA 52242-1009 |
| Practice Telephone | 3193561789 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 083720 | IA | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570746 | Kelly Susan Wagner | Speech-Language Pathologist | 8902 Old Harford Rd, Baltimore, MD 21234-2646 | 2019-04-18 |
| 1356808455 | Kelly Mcmahon Wagner | Social Worker | 4701 Greenspring Ave, Baltimore, MD 21209-4704 | 2019-02-25 |
| 1659744316 | Kelly Ann Wagner | Nurse Practitioner | 10410 Abercorn Expressway, Savannah, GA 31419 | 2015-11-03 |
| 1659612745 | Kelly Ann Wagner | Specialist | 727 Carmen Dr, Norristown, PA 19401-3545 | 2013-03-14 |
| 1881925592 | Kelly Danielle Wagner | Physical Therapy Assistant | 226 Fish Hall Rd, Brunswick, GA 31523-7405 | 2010-01-20 |
| 1407180268 | Kelly Ann Wagner | Licensed Practical Nurse | 1143 Vogt Dr Apt 14, West Bend, WI 53095-5505 | 2009-09-28 |
| 1154776334 | Kelly Wagner | Student in an Organized Health Care Education/Training Program | 100 High St, C 378, Buffalo, NY 14203-1126 | 2016-04-26 |
| 1346613205 | Kelly Wagner | Naturopath | 185 Tilley Dr, Suite #51, South Burlington, VT 05403-4484 | 2015-11-01 |
| 1932510831 | Kelly Wagner | Pharmacist | 3360 Tittabawassee Rd, Saginaw, MI 48604-9453 | 2014-05-13 |
| 1235562307 | Kelly Anne Wagner | Speech-Language Pathologist | 331 E Park St, Weiser, ID 83672-2053 | 2013-08-13 |
| Street Address |
200 HAWKINS DR FOOD AND NUTRITION SERVICES, W146 GH |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52242-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425963 | Matthew T Spragg | Emergency Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-05-24 |
| 1205437951 | Jennifer Renee Manternach | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-07 |
| 1144821794 | Jannet S Eastman | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-02 |
| 1043810245 | Abbey Lorraine Foglesong | Dietitian, Registered | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-27 |
| 1972101533 | Lindy Pelzer | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-15 |
| 1124626437 | Georgianne Younger | Genetic Counselor, MS | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-09 |
| 1114534237 | Bharatendu Chandra | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1023625142 | Moon Ley Tung | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1225645187 | Sinan Akay | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1376158170 | Aygun Asgarli | Psychiatry & Neurology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738679 | Shannon Louise Miers | Physical Therapist | Ui Sports Medicine (iosmr), 2701 Prairie Meadow Drive, Iowa City, IA 52242 | 2020-04-14 |
| 1821624230 | Victoria Troesch | Student in an Organized Health Care Education/Training Program | 375 Newton Rd, Iowa City, IA 52242 | 2020-03-17 |
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1407330483 | Kristin L Heider | Psychologist | 616 E Bloomington Street, Iowa City, IA 52242 | 2018-09-17 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1528544780 | Abigail Lynne Schiltz | Physician Assistant | 200 Hawkins Dr 01290a Pfp, Iowa City, IA 52242 | 2018-07-11 |
| 1710474259 | Bashar H. H. Abuqayas | Hospitalist | 200 Hawkins Dr, Se 636 Gh, Uihc-internal Medicine, Iowa City, IA 52242 | 2018-04-19 |
| 1023547395 | Tyler Quist | Internal Medicine | 200 Hawkins Dr Dept of Ophthalmology, Iowa City, IA 52242 | 2017-06-08 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1649667734 | Jennie Sertterh | Specialist/Technologist | 1 Elliot Drive, S181 Carver Hawkeye Arena, Iowa City, IA 52242 | 2015-04-16 |
| Find all providers in zip 52242 | ||||
| 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 |
|---|---|---|---|---|
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1093360323 | Nichole Prelip | Dietitian, Registered | 200 Hawkins Dr # Ghw143, Iowa City, IA 52242-1009 | 2019-08-05 |
| 1043793912 | Taylor Mcdaniel | Dietitian, Registered | 200 Hawkins Dr # W146gh, Iowa City, IA 52242-1009 | 2018-09-07 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1740720713 | Anna Lindsley | Dietitian, Registered | 736 Michael St Apt 12, Iowa City, IA 52246-5526 | 2017-02-24 |
| 1194263053 | Julie Eichenberger | Dietitian, Registered | 824 Rider St, Iowa City, IA 52246-2429 | 2017-02-10 |
| 1083045892 | Julie Louise Gallagher | Dietitian, Registered | 1720 Waterfront Drive, Iowa City, IA 52240 | 2013-12-04 |
| 1699727248 | Elizabeth Dorothy Carlson | Dietitian, Registered | Highway 6, 002c, Iowa City, IA 52246 | 2006-05-16 |
| 1043810245 | Abbey Lorraine Foglesong | Dietitian, Registered | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-27 |
| 1861036840 | Carissa Marie Brown | Dietitian, Registered | 200 Hawkins Drive, Iowa City, IA 52242-1051 | 2019-11-01 |
| Find all providers in IOWA CITY | ||||
Please comment or provide details below to improve the information on KELLY WAGNER.
| 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.