Jessica Buckmire

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND8962 Issued in FL

Practice address

10040 Sheridan St Apt 310
Pembroke Pines, FL 33024-8542

Phone

(954) 397-0338

NPI assigned

May 5, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1063201283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19191 NW 23RD PL",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330295346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 SHERIDAN ST APT 310",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330248542",
            "telephone_number": "954-397-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKMIRE",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND8962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Brysman
• BSMS Pembroke LLC
• Brian Bucalo, M.D
• Jason M. Buchwald, M.D.
• Joseph Michael Buckley, D.C.
• Shakera Ann Marie Bucknor Ingram
• Brandon Budd
• Ashley Bui
• Andres Builes, OT/L
• Maria Clara Buitrago, RBT

• Registered Dietitian in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.