Active NPI
Jamey A Baietto, RD
- Registered Dietitian
- Springfield, IL
National Provider Identifier
1184387573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.007582
- Practice address
- 319 E Madison St Ste 1F
Springfield, IL 62701-3118 - Phone
- (217) 788-3948
- Fax
- (217) 527-3209
- NPI assigned
- Oct 21, 2021
- Sex
- Female
- 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 | 164.007582 | IL | Primary |
Addresses
Primary practice location
319 E Madison St Ste 1F
Springfield, IL 62701-3118
Mailing address
PO Box 3428
Springfield, IL 62708-3428
Phone (217) 588-2624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164007582 | Other | IL | RD LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.007582 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | 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": "1634774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1184387573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3428",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627083428",
"telephone_number": "217-588-2624",
"fax_number": "217-757-7550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 E MADISON ST STE 1F",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627013118",
"telephone_number": "217-788-3948",
"fax_number": "217-527-3209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAIETTO",
"first_name": "JAMEY",
"middle_name": "A",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-21",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.007582",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RD LICENSE",
"identifier": "164007582",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.