Active NPI
Jeffrey Martello, RD, LDN
- Registered Dietitian
- Mount Airy, NC
National Provider Identifier
1174296669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- L004826
- Practice address
- 830 Rockford St
Mount Airy, NC 27030-5322 - Phone
- (336) 847-0783
- NPI assigned
- Jul 29, 2021
- Sex
- Male
- 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 | L004826 | NC | Primary |
Addresses
Primary practice location
830 Rockford St
Mount Airy, NC 27030-5322
Mailing address
1905 Cross Pond Dr
Colfax, NC 27235-9636
Phone (336) 847-0783
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
| License | State | Type | Specialty |
|---|---|---|---|
| L004826 | NC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627516800000",
"number": "1174296669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 CROSS POND DR",
"city": "COLFAX",
"state": "NC",
"postal_code": "272359636",
"telephone_number": "336-847-0783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 ROCKFORD ST",
"city": "MOUNT AIRY",
"state": "NC",
"postal_code": "270305322",
"telephone_number": "336-847-0783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTELLO",
"first_name": "JEFFREY",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-29",
"last_updated": "2021-07-29",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NC",
"license": "L004826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Airy, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.