Active NPI
Jessica Rae Graumann, M.S., R.D., L.D.
- Registered Dietitian
- Minneapolis, MN
National Provider Identifier
1063772176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3044
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Phone
- (402) 943-6948
- NPI assigned
- May 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 3044 | MN | Primary |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 3044 | MN |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Mailing address
2450 Riverside Ave
Minneapolis, MN 55454-1450
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3044 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1063772176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "402-943-6948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAUMANN",
"first_name": "JESSICA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "M.S., R.D., L.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-22",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "3044",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "MN",
"license": "3044",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.