IndividualActiveAccepts Medicare

Jennifer Wagner, RDN

NPI 1336865104 · Registered Dietitian · Largo, FL

Enrolled with Medicare as Practitioner - Registered Dietitian Or Nutrition Professional · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1336865104
Entity type: Individual
Primary specialty: Registered DietitianDietary & Nutritional Service Providers
Credential: RDN
Sex: Female
Sole proprietor: No
License: DT90667 (TX)

Specialties & taxonomies

Registered DietitianPrimary133V00000XLicense 11315 (FL)
Dietary & Nutritional Service Providers
Registered Dietitian133V00000XLicense DT90667 (TX)
Dietary & Nutritional Service Providers
Registered Dietitian133V00000X
Dietary & Nutritional Service Providers
Registered Dietitian133V00000X
Dietary & Nutritional Service Providers
Registered Dietitian133V00000XLicense L008231 (NC)
Dietary & Nutritional Service Providers
Registered Dietitian133V00000X
Dietary & Nutritional Service Providers

Profile Score

Established profile(69/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
3 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
6 documented practice locations

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

13801 Walsingham Rd # A-164

Largo, FL 33774-3237

Phone: (206) 226-1664

Street-level locationGet directions

More FL providers

Mailing address

14887 Seminole Trl

Seminole, FL 33776-1081

Additional practice locations (5)

655 E River Rd Unit 201
Tucson, AZ 85704-5853
Phone: (206) 895-4292
Fax: (833) 973-4037
5323 4th Avenue Cir E
Bradenton, FL 34208-5623
Phone: (206) 895-4292
Fax: (833) 973-4033
200 Perimeter Park Dr Ste C
Morrisville, NC 27560-9714
Phone: (206) 895-4292
Fax: (833) 973-4034
6100 Harris Pkwy Ste 140
Fort Worth, TX 76132-4130
Phone: (206) 895-4292
828 Healthy Way Ste 330
Virginia Beach, VA 23462-7959
Phone: (206) 895-4292

Enumerated: 2022-10-13
Last updated: 2025-04-17
Certified: 2025-04-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.