Individual provider Active NPI

Jennifer Elizabeth Filler, RD, CD-N, CDE

  • Registered Dietitian
  • Brooklyn, NY
National Provider Identifier
1003867920
Registry record updated Dec 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
006101-1 Issued in NY
Practice address
240 Willoughby St
Suite 11E
Brooklyn, NY 11201-5465
Phone
(718) 250-8866
Fax
(718) 250-6705
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 006101-1 NY Primary

Addresses

Primary practice location

240 Willoughby St
Suite 11E
Brooklyn, NY 11201-5465

Mailing address

496 1/2 6TH Ave
Brooklyn, NY 11215-4905
Phone (631) 766-9382

Other identifiers 1

IdentifierTypeStateIssuer
03095723MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006101NYMDAcupuncturist
006101-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323475200000",
    "number": "1003867920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 1/2 6TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154905",
            "telephone_number": "631-766-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOUGHBY ST",
            "address_2": "SUITE 11E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015465",
            "telephone_number": "718-250-8866",
            "fax_number": "718-250-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLER",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "RD, CD-N, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "006101-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03095723",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.