Individual provider Active NPI

Jessica Marshall Regan, RDN, LDN, FMN, CLT

  • Registered Dietitian
  • Wexford, PA
National Provider Identifier
1124407176
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN005561 Issued in PA
Practice address
117 Vip Dr Ste 310
Wexford, PA 15090-6936
Phone
(724) 934-3905
NPI assigned
May 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN005561 PA Primary

Addresses

Primary practice location

117 Vip Dr Ste 310
Wexford, PA 15090-6936

Mailing address

70 Allen Dr
Pittsburgh, PA 15214-1402
Phone (724) 984-3911

Other practice location 1

2 Monastery St
Pittsburgh, PA 15203-1407
Phone (724) 984-3911

Other practice location 2

70 Allen Dr
Pittsburgh, PA 15214-1402
Phone (724) 984-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160707000032 PA Practitioner - Registered Dietitian Or Nutrition Professional 1557653854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Allen Dr
Pittsburgh, PA 15214-1402
Phone (724) 984-3911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN005561PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Eater LLC CurrentSince Jul 3, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1124407176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 ALLEN DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152141402",
            "telephone_number": "724-984-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 VIP DR STE 310",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906936",
            "telephone_number": "724-934-3905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Monastery St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152031407",
            "country_code": "US",
            "telephone_number": "724-984-3911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Allen Dr",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152141402",
            "country_code": "US",
            "telephone_number": "724-984-3911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGAN",
        "first_name": "JESSICA",
        "middle_name": "MARSHALL",
        "credential": "RDN, LDN, FMN, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN005561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.