Active NPI
Emily Rose Nutrition, LLC
Doing business as NuSparkle Nutrition
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1174139679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- EMILY ROSE NUTRITION, LLC
- Doing business as
- NuSparkle Nutrition
- Practice address
- 12866 Daybreak CT E
Jacksonville, FL 32246-7095 - Phone
- (904) 497-0401
- Fax
- (833) 773-1288
- NPI assigned
- Sep 20, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Emily Rose Conyers, MS, RDN, CSR, LD/N
- Title
- Founder, Ceo, & Dietitian
- Phone
- (904) 497-0401
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | |||
| Nutrition Education Nutritionist | 133NN1002X | |||
| Registered Dietitian | 133V00000X | Primary | ||
| Renal Nutrition Registered Dietitian | 133VN1005X | |||
| Metabolic Nutrition Registered Dietitian | 133VN1006X | |||
| Gerontological Nutrition Registered Dietitian | 133VN1101X | |||
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | |||
| Oncology Nutrition Registered Dietitian | 133VN1301X | |||
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X |
Addresses
Primary practice location
12866 Daybreak CT E
Jacksonville, FL 32246-7095
Mailing address
12866 Daybreak CT E
Jacksonville, FL 32246-7095
Phone (904) 497-0401
Other names 1
- NuSparkle Nutrition
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4320 Deerwood Lake Pkwy
Ste 101140
Jacksonville, FL 32216
Phone (904) 497-0401
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Dietitian
- Jacksonville, FL
- NPI 1811474695
Nutritionist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780704000000",
"number": "1174139679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12866 DAYBREAK CT E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322467095",
"telephone_number": "904-497-0401",
"fax_number": "833-773-1288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12866 DAYBREAK CT E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322467095",
"telephone_number": "904-497-0401",
"fax_number": "833-773-1288"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMILY ROSE NUTRITION, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-20",
"last_updated": "2026-06-06",
"certification_date": "2026-06-06",
"status": "A",
"authorized_official_last_name": "CONYERS",
"authorized_official_first_name": "EMILY",
"authorized_official_middle_name": "ROSE",
"authorized_official_title_or_position": "FOUNDER, CEO, & DIETITIAN",
"authorized_official_telephone_number": "904-497-0401",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MS, RDN, CSR, LD/N"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "133NN1002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
},
{
"code": "133VN1005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Gerontological",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1301X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1501X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "NuSparkle Nutrition",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.