Active NPI
Jessica Jasmine Waite, RD
- Registered Dietitian
- New York, NY
National Provider Identifier
1043934086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 010653-01
- Practice address
- 1428 Madison Ave
Atran Building, First Floor
New York, NY 10029-6508 - Phone
- (212) 241-6947
- Fax
- (212) 860-3316
- NPI assigned
- Oct 3, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 010653-01 | NY | |
| Registered Dietitian | 133V00000X | 010653-01 | NY | Primary |
Addresses
Primary practice location
1428 Madison Ave
Atran Building, First Floor
New York, NY 10029-6508
Mailing address
Department of Genetics & Genomic Sciences
One Gustave L Levy Place, PO Box 1497
New York, NY 10029
Phone (212) 241-0922
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 2128600922 | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010653-01 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1043934086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPARTMENT OF GENETICS & GENOMIC SCIENCES",
"address_2": "ONE GUSTAVE L LEVY PLACE, PO BOX 1497",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10029",
"telephone_number": "212-241-0922",
"fax_number": "212-860-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 MADISON AVE",
"address_2": "ATRAN BUILDING, FIRST FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296508",
"telephone_number": "212-241-6947",
"fax_number": "212-860-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITE",
"first_name": "JESSICA",
"middle_name": "JASMINE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "NY",
"license": "010653-01",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "010653-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "2128600922",
"affiliation": "N",
"endpointDescription": "secure fax line",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"contentOtherDescription": "direct address",
"address_1": "1428 Madison Ave",
"address_2": "Atran Building, first floor",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100296508",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.