Active NPI
Stefanie Kaitlyn Jensen, RD, LD
- Registered Dietitian
- Saint Paul, MN
National Provider Identifier
1003556622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86168535
- Practice address
- 2265 Como Ave
Saint Paul, MN 55108-1737 - Phone
- (888) 364-5977
- NPI assigned
- Mar 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86168535 | Primary |
Addresses
Primary practice location
2265 Como Ave
Saint Paul, MN 55108-1737
Mailing address
900 Hoyt Ave W
Saint Paul, MN 55117-3301
Phone (515) 314-6079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emily Program P C | Current | Accepting new patients |
Locations
2265 Como Ave
Saint Paul, MN 55108
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1528165065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1003556622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 HOYT AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551173301",
"telephone_number": "515-314-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2265 COMO AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551081737",
"telephone_number": "888-364-5977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "STEFANIE",
"middle_name": "KAITLYN",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-31",
"last_updated": "2022-03-31",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86168535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.