Individual provider Active NPI

Jodi Serafin, RD

  • Registered Dietitian
  • Waldorf, MD
National Provider Identifier
1205374956
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D02402 Issued in MD
Practice address
3261 Old Washington Rd
Ste 2020
Waldorf, MD 20602-3231
Phone
(240) 448-6181
NPI assigned
Feb 2, 2017
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 D02402 MD Primary

Addresses

Primary practice location

3261 Old Washington Rd
Ste 2020
Waldorf, MD 20602-3231

Mailing address

3261 Old Washington Rd
Ste 2020
Waldorf, MD 20602-3231
Phone (240) 448-6181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813002896 MD Practitioner - Registered Dietitian Or Nutrition Professional 9335497023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Nutrition Company LLCGroup PAC ID 2062804008, 3 clinicians

Practice addresses (Care Compare)

1829 Reisterstown Rd
Suite 350
Pikesville, MD 21208-7126
Phone (240) 448-6181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D02402MDMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Nutrition Company LLC Dietitian, Registered CurrentSince Dec 1, 2021 Accepting new patients

Locations

1829 Reisterstown Rd
Ste 350
Pikesville, MD 21208
Phone (443) 226-1676

3261 Old Washington Rd
Ste 2020
Waldorf, MD 20602
Phone (240) 419-2412

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1205374956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD",
            "address_2": "STE 2020",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023231",
            "telephone_number": "240-448-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD",
            "address_2": "STE 2020",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023231",
            "telephone_number": "240-448-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFIN",
        "first_name": "JODI",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "D02402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.