Active NPI
Julie Avery, RDN CLC
- Registered Dietitian
- St Augustine, FL
National Provider Identifier
1033899257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86118496
- Practice address
- 120 Palencia Village Dr # C-105167
St Augustine, FL 32095-8549 - Phone
- (904) 417-8132
- NPI assigned
- Jul 21, 2023
- 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 | 86118496 | Primary |
Addresses
Primary practice location
120 Palencia Village Dr # C-105167
St Augustine, FL 32095-8549
Mailing address
120 Palencia Village Dr # C-105167
St Augustine, FL 32095-8549
Phone (904) 417-8132
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1033899257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PALENCIA VILLAGE DR # C-105167",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320958549",
"telephone_number": "904-417-8132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 PALENCIA VILLAGE DR # C-105167",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320958549",
"telephone_number": "904-417-8132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "JULIE",
"name_prefix": "Dr.",
"credential": "RDN CLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-21",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86118496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.