Individual provider Active NPI

Mackenzie Stanley Rafuls, RDN

  • Registered Dietitian
  • Jacksonville, FL
National Provider Identifier
1023967106
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND14392 Issued in FL
Practice address
11555 Central Pkwy Ste 703
Jacksonville, FL 32224-2699
Phone
(904) 402-7677
NPI assigned
Jan 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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 ND14392 FL Primary

Addresses

Primary practice location

11555 Central Pkwy Ste 703
Jacksonville, FL 32224-2699

Mailing address

11555 Central Pkwy Ste 703
Jacksonville, FL 32224-2699
Phone (904) 402-7677

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND14392FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1769040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1023967106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242699",
            "telephone_number": "904-402-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 CENTRAL PKWY STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242699",
            "telephone_number": "904-402-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFULS",
        "first_name": "MACKENZIE",
        "middle_name": "STANLEY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND14392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.