Johnathon Scott Primmer, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86294236 Issued in CA

Practice address

10418 Valley Blvd Ste a
El Monte, CA 91731-3600

Phone

(626) 258-1600

NPI assigned

May 12, 2022

Last updated

May 17, 2022By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1043957996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 215TH ST APT 12",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907152071",
            "telephone_number": "719-648-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10418 VALLEY BLVD STE A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313600",
            "telephone_number": "626-258-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11400 215th St Apt 12",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CA",
            "postal_code": "907152071",
            "country_code": "US",
            "telephone_number": "719-648-2821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIMMER",
        "first_name": "JOHNATHON",
        "middle_name": "SCOTT",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86294236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION OF DIETETICS REGISTERED",
            "identifier": "86294236",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in El Monte, CA
• Providers in El Monte, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.