Jessica Elaine Lake, MS, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN007374 Issued in PA

Practice address

3910 Caughey Rd Ste 200
Erie, PA 16506-4098

Phone

(814) 580-8808

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Jessy Brinling Nutrition LLC

  • Registered Dietitian
  • Erie, PA
  • NPI 1669234381

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1154910214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 CAUGHEY RD STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064098",
            "telephone_number": "814-580-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CAUGHEY RD STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064098",
            "telephone_number": "814-580-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9345 Lake Pleasant Rd",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165095755",
            "country_code": "US",
            "telephone_number": "814-580-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKE",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.09340",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN007374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Erie Orthopaedics LLC
• Lake Erie Podiatry, LLC
• Lake Erie Spine and Injury Center
• Lake Erie Womens Center
• Lake Shore Fire Department
• Lakeland Area Hospice LP
• Lakeshore Community Services, Inc.
• Lakeshore Comunity Services, Inc.
• Holly Lalewicz
• Lamar Neal, PSYD P.C.

• Registered Dietitian in Erie, PA
• Providers in Erie, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.