Active NPI
Jenna McDougall, R.D.N., L.D.
- Registered Dietitian
- Minneapolis, MN
National Provider Identifier
1124478672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 3709
- Practice address
- 621 W Lake St Ste 350
Minneapolis, MN 55408-2952 - Phone
- (651) 983-4391
- NPI assigned
- Jun 15, 2016
- 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 | 3709 | MN | Primary |
Addresses
Primary practice location
621 W Lake St Ste 350
Minneapolis, MN 55408-2952
Mailing address
2104 Sargent Ave
Saint Paul, MN 55105-1125
Phone (651) 983-4391
Other practice location 1
7201 Metro Blvd Ste 550
Edina, MN 55439-1353
Phone (651) 983-4391
Other names 1
- Jenna Schuder
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809002401 | MN | Practitioner - Registered Dietitian Or Nutrition Professional | 6709170087 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3709 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1124478672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 SARGENT AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551051125",
"telephone_number": "651-983-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 W LAKE ST STE 350",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082952",
"telephone_number": "651-983-4391"
}
],
"practiceLocations": [
{
"address_1": "7201 Metro Blvd Ste 550",
"address_purpose": "LOCATION",
"city": "Edina",
"state": "MN",
"postal_code": "554391353",
"country_code": "US",
"telephone_number": "651-983-4391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDOUGALL",
"first_name": "JENNA",
"credential": "R.D.N., L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "3709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNA",
"last_name": "SCHUDER",
"code": "1",
"type": "Former Name"
}
]
}
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 Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.