Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shannon M Wiederholt, RD, LDN, CDE

Individual provider Registered Dietitian · NPI 1972647287

Mrs. Shannon M Wiederholt, RD, LDN, CDE is a Registered Dietitian in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2007.

Licensed in
TN
In the registry since
2007
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
LDN — Licensed Dietitian Nutritionist
A state-licensed dietitian nutritionist.
CDE — Certified Diabetes Educator
Teaches people to manage diabetes day to day.

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Practice location Address checks out

408 N State Of Franklin Rd SUITE#31
Johnson City, TN 37604-6089
Phone: (423) 461-8880
Fax: (423) 461-8887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 1075 (TN)

Record details

NPI number1972647287
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD , LDN , CDE
Sole proprietorNo
NPI enumeratedFebruary 19, 2007
Last updated in NPPESJuly 8, 2007

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