Active NPI
Jacklyn Marie Van Arsdale, RD, LDN, LPC
- Registered Dietitian
- Salunga, PA
National Provider Identifier
1184909541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN004686
- Practice address
- 101 W Main St Unit G2
Salunga, PA 17538-1109 - Phone
- (267) 402-0252
- Fax
- (717) 618-8376
- NPI assigned
- Oct 18, 2011
- Last updated
- Aug 1, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PC012543 | PA | |
| Professional Counselor | 101YP2500X | PC012543 | PA | |
| Registered Dietitian | 133V00000X | DN004686 | PA | Primary |
Addresses
Primary practice location
101 W Main St Unit G2
Salunga, PA 17538-1109
Mailing address
176B Middle Creek Rd
Lititz, PA 17543-8894
Phone (267) 402-0252
Other practice location 1
500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455
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 |
|---|---|---|---|
| PC012543 | PA | MD | Counselor |
| DN004686 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid Atlantic Nutrition Specialists, LLC | 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.
-
- Registered Dietitian
- Lancaster, PA
- NPI 1841690237
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596240000000",
"number": "1184909541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176B MIDDLE CREEK RD",
"city": "LITITZ",
"state": "PA",
"postal_code": "175438894",
"telephone_number": "267-402-0252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W MAIN ST UNIT G2",
"city": "SALUNGA",
"state": "PA",
"postal_code": "175381109",
"telephone_number": "267-402-0252",
"fax_number": "717-618-8376"
}
],
"practiceLocations": [
{
"address_1": "500 University Dr",
"address_purpose": "LOCATION",
"city": "Hershey",
"state": "PA",
"postal_code": "170332360",
"country_code": "US",
"telephone_number": "800-243-1455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN ARSDALE",
"first_name": "JACKLYN",
"middle_name": "MARIE",
"credential": "RD, LDN, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-18",
"last_updated": "2020-08-01",
"certification_date": "2020-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "PC012543",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC012543",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salunga, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.