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MERCEDES WAUGAMAN MS, RDN, LDN
NPI 1699545152
Dietitian, Registered in Jacksonville, FL

Active since January 05, 2024
10752 DEERWOOD PARK BLVD STE 100, JACKSONVILLE, FL 32256(904) 763-9722(904) 833-3377 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 15, 2025, Jan 5, 2024 (2 updates tracked since 2024).

About Mercedes Waugaman Ms, Rdn, Ldn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MERCEDES WAUGAMAN MS, RDN, LDN (NPI 1699545152) is an individual dietitian, registered in Jacksonville, Florida, licensed in Florida (ND12737) and active in the NPI registry since January 2024. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1699545152
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMERCEDES WAUGAMANCredential: MS, RDN, LDN
Location Address10752 DEERWOOD PARK BLVD STE 100Jacksonville, FL 32256-4846
Mailing Address5274 Legacy Pines WayJacksonville, FL 32224-4410 · (904) 382-2228 · Fax (904) 833-3377
Phone(904) 763-9722
Fax(904) 833-3377
Sole ProprietorNo
Enumeration DateJanuary 5, 2024
Last NPPES UpdateDecember 15, 20252 updates tracked since enumeration
NPPES CertifiedDecember 15, 2025
✔ NPI 1699545152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in FL · ND12737
Definition
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.
Also ListedDietitian, Registered · Nutrition, PediatricTaxonomy 133VN1004X · License ND12737 (FL)
Also ListedDietitian, Registered · Nutrition, Obesity and Weight ManagementTaxonomy 133VN1201X · License ND12737 (FL)
10752 DEERWOOD PARK BLVD STE 100, Jacksonville, FL 32256
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11200 Riverplace Blvd Ste 1051218Jacksonville, FL 32207-9046 · Phone (904) 382-2228
Location 24500 San Pablo Rd SJacksonville, FL 32224-1865 · Phone (904) 953-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mercedes Waugaman Ms, Rdn, Ldn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

2

Medicare enrollment records show Mercedes Waugaman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Purevital Nutrition LLC
Same address
Dietitian, Registered
10752 DEERWOOD PARK BLVD STE 100
Jacksonville, FL 32256
  • Reassigned Medicare billing, Florida enrollment
NPI 1285598102 (904) 763-9722
Mayo Clinic Jacksonville
5.4 mi
Health Service
4500 SAN PABLO RD S
Jacksonville, FL 32224
  • Reassigned Medicare billing, Florida enrollment
  • 1,828 clinicians in this Medicare group
NPI 1174143986 (904) 953-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BOBBI'S TOTAL CARE SOLUTIONS LLC
Nurse Practitioner
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 800-4775
CRYSTAL A CISZEK FNP
Nurse Practitioner (Family)
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (478) 290-0677
MS. DERDA JACKSON LMHC
Counselor (Mental Health)
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 776-1061
INTEGRATIVE DIMENSIONAL HEALING, LLC
Community/Behavioral Health
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 806-4837
WININGS WELLNESS LLC
Nurse Practitioner (Psychiatric/Mental Health)
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 800-4775
ERIN THERESA SMITH
Nurse Practitioner (Psychiatric/Mental Health)
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 800-4775
DR. SAMANTHA MARIE REIMAN PH.D.
Psychologist (Clinical)
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 925-6562
PUREVITAL NUTRITION LLC
Dietitian, Registered
10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE, FL 32256
Duval County (904) 763-9722

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mercedes Waugaman's NPI number?

The NPI number for Mercedes Waugaman is 1699545152. It was assigned to this individual provider in the NPPES registry on January 5, 2024.

Where is Mercedes Waugaman located?

Mercedes Waugaman practices at 10752 Deerwood Park Blvd Ste 100, Jacksonville, FL 32256. The listed phone number is (904) 763-9722.

What is Mercedes Waugaman's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Mercedes Waugaman enrolled in Medicare?

Yes. Mercedes Waugaman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mercedes Waugaman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mercedes Waugaman reassigns Medicare benefits to 2 organizations: Purevital Nutrition LLC (Jacksonville, FL) and Mayo Clinic Jacksonville (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mercedes Waugaman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mercedes Waugaman was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.