Active NPI
Jo Lichten, PHD, RDN
- Registered Dietitian
- Fernandina Beach, FL
National Provider Identifier
1164019188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- R592040
- Practice address
- 86135 Hampton Bays Dr
Fernandina Beach, FL 32034-8130 - Phone
- (954) 235-0371
- NPI assigned
- Dec 23, 2020
- 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 | R592040 | FL | Primary |
Addresses
Primary practice location
86135 Hampton Bays Dr
Fernandina Beach, FL 32034-8130
Mailing address
86135 Hampton Bays Dr
Fernandina Beach, FL 32034-8130
Phone (954) 235-0371
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R592040 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1164019188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86135 HAMPTON BAYS DR",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320348130",
"telephone_number": "954-235-0371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86135 HAMPTON BAYS DR",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320348130",
"telephone_number": "954-235-0371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHTEN",
"first_name": "JO",
"credential": "PHD, RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-23",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "R592040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.