Jennifer Seidel Ellsworth, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

718188 Issued in VT

Practice address

110 N 4TH Ave
Ann Arbor, MI 48104-5503

Phone

(734) 431-4735

NPI assigned

Oct 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Ruth Seidel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• County of Washtenaw

  • State or Local Public Health Clinic/Center
  • Ypsilanti, MI
  • NPI 1609896018
  NPD (past)
• County of Washtenaw

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ypsilanti, MI
  • NPI 1639132442
  NPD (past)

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1124353255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-431-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-431-4735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Towner St",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481985723",
            "country_code": "US",
            "telephone_number": "734-431-4735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "JENNIFER",
        "middle_name": "SEIDEL",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VT",
            "license": "718188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SEIDEL",
            "middle_name": "RUTH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sean Brett Ellis, DPT
• Shannon Hope Ellis
• Grant Martin Ellison, MS LLP
• Justin M Ellison, PA-C
• Ryan K Ellison, CRNA
• Lindsay Ann Ellsworth, M.D.
• Cassie M Ellul, NP
• Royda Abdo Elmathil, PA-C
• Ray Par Elmblad, CRNA
• Mariam Elmoghrabi

• Registered Dietitian in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.