Jennifer Beazer, RDN LD

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

79779 Issued in MT

Practice address

202 Conway Dr Ste 200
Kalispell, MT 59901-3153

Phone

(406) 751-4188

NPI assigned

Jan 20, 2014

Last updated

Jan 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1053733428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 1ST AVE W UNIT 1342",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599037056",
            "telephone_number": "208-789-9668",
            "fax_number": "208-381-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CONWAY DR STE 200",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013153",
            "telephone_number": "406-751-4188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Idaho St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837126270",
            "country_code": "US",
            "telephone_number": "208-381-7081",
            "fax_number": "208-381-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAZER",
        "first_name": "JENNIFER",
        "credential": "RDN LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-20",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "MT",
            "license": "79779",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "ID",
            "license": "D470",
            "primary": false
        },
        {
            "code": "133VN1401X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric Critical Care",
            "state": "MT",
            "license": "79779",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MT",
            "license": "79779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Metabolic Nutrition Registered Dietitian in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Metabolic Nutrition Registered Dietitian in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.