Individual provider Active NPI

Jennifer Marie Doane, RD

  • Registered Dietitian
  • Allentown, PA
National Provider Identifier
1164460440
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN001283 Issued in PA
Practice address
961 Marcon Blvd
Suite 115
Allentown, PA 18109-9371
Phone
(610) 443-1885
Fax
(610) 443-1685
NPI assigned
Jun 2, 2006
Last updated
May 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN001283 PA Primary

Addresses

Primary practice location

961 Marcon Blvd
Suite 115
Allentown, PA 18109-9371

Mailing address

961 Marcon Blvd
Suite 115
Allentown, PA 18109-9371
Phone (610) 443-1885

Other identifiers 2

IdentifierTypeStateIssuer
2378865OtherPAAETNA ID #
00774560MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060605000222 PA Practitioner - Registered Dietitian Or Nutrition Professional 4385655422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Nutrition and Wellness, LLCGroup PAC ID 2961549860, 2 clinicians

Practice addresses (Care Compare)

961 Marcon Blvd
Suite 115
Allentown, PA 18109-9371
Phone (610) 443-1885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Nutrition & Wellness, LLC Dietitian, Registered CurrentSince Aug 10, 2009 Accepting new patients

Locations

961 Marcon Blvd
Ste 115
Allentown, PA 18109
Phone (610) 443-1885

2005 City Line Rd
Ste 104
Bethlehem, PA 18017
Phone (610) 443-1885

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1164460440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD",
            "address_2": "SUITE 115",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099371",
            "telephone_number": "610-443-1885",
            "fax_number": "610-443-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD",
            "address_2": "SUITE 115",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099371",
            "telephone_number": "610-443-1885",
            "fax_number": "610-443-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOANE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN001283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "2378865",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00774560",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.