Shanta Dayjah Jackson, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86289730 Issued in VA

Practice address

8266 Atlee Rd Ste 215
Mechanicsville, VA 23116-1805

Phone

(804) 248-3878

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• TX HMO

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.

• Bon Secours Medical Group Richmond Specialty Care LLC

  • Cardiovascular Disease Physician
  • Richmond, VA
  • NPI 1477112225
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Richmond Specialty Care LLC

  dba Bon Secours Orthopedic Specialists

  • Durable Medical Equipment & Medical Supplies
  • Midlothian, VA
  • NPI 1841029287
  NPD
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1013758374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8266 ATLEE RD STE 215",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8266 ATLEE RD STE 215",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161805",
            "telephone_number": "804-248-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHANTA",
        "middle_name": "DAYJAH",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "86289730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thais Issa-Weedon
• Theresa Izzo, P.T.
• Kaydreyanna Jackson
• Laura M Jackson, MS, CCC-SLP
• Rebecca Jackson, LPT
• Verneeky Carenda Jackson, PERSONAL CARE AIDE
• Patricia Jacob, P.T.
• Saeed Jadali, M.D.
• Annabelle Claire Jajuga
• James H Cane MD PC

• Registered Dietitian in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.