Cecilia Bernadette Hennig, RD,LD/N,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND65 Issued in FL

Practice address

1 Shircliff Way
Suite 1830
Jacksonville, FL 32204-4748

Phone

(904) 308-8794

Fax

(904) 308-2958

NPI assigned

Jul 25, 2008

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)

Enrolled

State licenses

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1083879308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "address_2": "SUITE 1830",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "address_2": "SUITE 1830",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-8794",
            "fax_number": "904-308-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "CECILIA",
        "middle_name": "BERNADETTE",
        "name_prefix": "Ms.",
        "credential": "RD,LD/N,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND65",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michele Henley-Brown, DDS
• CJ Henley, DMD
• Lewalie Julian Henley, DC
• Nia Henley, OTR/L
• Stephanie Reeder Henley, MD, D.M.D.
• Sydne M Hennings
• Lucna Henrisme, MD
• Jill E Henry Castellani, M.S., BCBA
• Henry Lepely MD PA
• Jonna Lynn Henry-Norton

• Registered Dietitian in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.