Active NPI
Janelle Marie Kennedy, REGISTERED DIETITIAN
- Registered Dietitian
- Seattle, WA
National Provider Identifier
1154794022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI60678012
- Practice address
- 1100 9TH Ave
Seattle, WA 98101-2756 - Phone
- (206) 223-6600
- NPI assigned
- Nov 2, 2015
- Last updated
- Dec 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4016 | MA | |
| Registered Dietitian | 133V00000X | DI60678012 | WA | Primary |
Addresses
Primary practice location
1100 9TH Ave
Seattle, WA 98101-2756
Mailing address
1100 9TH Ave
M4-PFS
Seattle, WA 98101-2756
Phone (206) 515-5811
Other names 1
- Janelle Derella
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI60678012 | WA | MD | Registered Dietitian |
| 4016 | MA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Nutrition | Dietitian, Registered | Current | Accepting new patients |
| 9Amhealth Medical Group of California, P.C. | Past | Accepting new patients | |
| 9Amhealth Medical Group, P.a. | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Family Medicine Physician
- Miami Beach, FL
- NPI 1982304713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576108800000",
"number": "1154794022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "M4-PFS",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "JANELLE",
"middle_name": "MARIE",
"credential": "REGISTERED DIETITIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-02",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4016",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "DI60678012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANELLE",
"last_name": "DERELLA",
"credential": "REGISTERED DIETITIAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.