Active NPI
Jessica Niemiec, MBA,RD
- Registered Dietitian
- Covington, IN
National Provider Identifier
1104748219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86417589
- Practice address
- 12008 Spring Creek Dr
Covington, IN 47932-7967 - Phone
- (847) 431-8069
- NPI assigned
- Jul 29, 2026
- Last updated
- Jul 29, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86417589 | IN | Primary |
Addresses
Primary practice location
12008 Spring Creek Dr
Covington, IN 47932-7967
Mailing address
12008 Spring Creek Dr
Covington, IN 47932-7967
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)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86417589 | IN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1104748219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12008 SPRING CREEK DR",
"city": "COVINGTON",
"state": "IN",
"postal_code": "479327967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12008 SPRING CREEK DR",
"city": "COVINGTON",
"state": "IN",
"postal_code": "479327967",
"telephone_number": "847-431-8069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEMIEC",
"first_name": "JESSICA",
"credential": "MBA,RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-29",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IN",
"license": "86417589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.