Individual provider Active NPI

Jessica Ann Iannotta, RD

  • Registered Dietitian
  • Monroe, CT
National Provider Identifier
1164043915
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
001665 Issued in CT
Practice address
324 Elm St Ste 203a
Monroe, CT 06468-2282
Phone
(646) 247-8589
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Nutrition Registered Dietitian 133VN1301X 001665 CT
Registered Dietitian 133V00000X 001665 CT Primary

Addresses

Primary practice location

324 Elm St Ste 203a
Monroe, CT 06468-2282

Mailing address

99 Settlers Farm Rd
Monroe, CT 06468-3324
Phone (646) 247-8589

Other practice location 1

300 Orchard St Rm E2100
New Haven, CT 06511-4412
Phone (203) 785-6060

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

LicenseStateTypeSpecialty
001665CTMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1164043915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 SETTLERS FARM RD",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064683324",
            "telephone_number": "646-247-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ELM ST STE 203A",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682282",
            "telephone_number": "646-247-8589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Orchard St Rm E2100",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114412",
            "country_code": "US",
            "telephone_number": "203-785-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANNOTTA",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "CT",
            "license": "001665",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "001665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.