Individual Healthcare Provider
Jennifer Anne Wagner, RDN
Provider's NPPES record last updated: April 17, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1336865104
- Primary Specialty
- Dietitian, Registered
- Practice Location
- Largo, Florida
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 11:17 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Dietitian, Registered
Dietary & Nutritional Service Providers
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Taxonomy code 133V00000X
Provider-Reported License Information
- Dietitian, Registered (Florida)
- 11315
- Dietitian, Registered (Texas)
- DT90667
- Dietitian, Registered (North Carolina)
- L008231
Practice Locations
Practice Location
13801 Walsingham Rd # A-164
Largo, Florida 33774-3237
Phone: (206) 226-1664
Additional Practice Location
5323 4th Avenue Cir E
Bradenton, Florida 34208-5623
Phone: (206) 895-4292
Fax: (833) 973-4033
Additional Practice Location
655 E River Rd Unit 201
Tucson, Arizona 85704-5853
Phone: (206) 895-4292
Fax: (833) 973-4037
Additional Practice Location
200 Perimeter Park Dr Ste C
Morrisville, North Carolina 27560-9714
Phone: (206) 895-4292
Fax: (833) 973-4034
Additional Practice Location
6100 Harris Pkwy Ste 140
Fort Worth, Texas 76132-4130
Phone: (206) 895-4292
Additional Practice Location
828 Healthy Way Ste 330
Virginia Beach, Virginia 23462-7959
Phone: (206) 895-4292
Record Information
- Enumeration Date
- October 13, 2022
- Provider's NPPES Record Last Updated
- April 17, 2025
- Certification Date
- April 17, 2025
- NPISignal NPPES Dataset
- August 2026
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