Jessica Lynn Edmonds, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

2920 Camarillo LN
Virginia Beach, VA 23456-1558

Phone

(904) 608-1068

NPI assigned

Nov 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

University of Texas at Austin Dell Medical School, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Beach Life Nutrition LLC

  • Registered Dietitian
  • Virginia Beach, VA
  • NPI 1053029710

  Dietitian, Registered

  Medicare reassignment NPD Authorized official
• Maxwell Nutrition

  • Registered Dietitian
  • Chesapeake, VA
  • NPI 1063138808

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1043928864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 CAMARILLO LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 CAMARILLO LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234561558",
            "telephone_number": "904-608-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR LICENSE",
            "identifier": "818706",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://lwell.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "2920 Camarillo Ln",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234561558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Mai Edge
• Gregory J Edinger, MD
• Victoria Edlan
• Serenity Edmond
• Beatrix K Edmonds, MD
• Kristen Edmonds, OTD
• Christina Kane Edmondson, M.ED., CCC/SLP
• Donna Rae Edmondson, LPTA
• Colette Denise Edmonson, LPC
• Brian H Edmunds, PT, NCS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.