Individual provider Active NPI

Jenifer Fournier, RDN

  • Registered Dietitian
  • Colorado Springs, CO
National Provider Identifier
1174154165
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1087143 Issued in CO
Practice address
1921 Fieldcrest Dr
Colorado Springs, CO 80921-4012
Phone
(719) 339-9763
NPI assigned
Jan 29, 2020
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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 1087143 CO Primary

Addresses

Primary practice location

1921 Fieldcrest Dr
Colorado Springs, CO 80921-4012

Mailing address

1921 Fieldcrest Dr
Colorado Springs, CO 80921-4012
Phone (719) 339-9763

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL charmhealth.com Health Information Exchange (HIE)

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

State licenses

LicenseStateTypeSpecialty
1087143COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Nutrition Services LLC Dietitian, Registered CurrentSince Mar 1, 2020 Accepting new patients

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1174154165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 FIELDCREST DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214012",
            "telephone_number": "719-339-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 FIELDCREST DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214012",
            "telephone_number": "719-339-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER",
        "first_name": "JENIFER",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "1087143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "charmhealth.com",
            "affiliation": "N",
            "endpointDescription": "Electronic EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1921 Fieldcrest Dr",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809214012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.