Individual provider Active NPI

Jennifer Ann Garibaldi, RD, LDN

  • Registered Dietitian
  • Pearland, TX
National Provider Identifier
1215354105
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86871 Issued in TX
Practice address
9720 Broadway St Apt 216
Pearland, TX 77584-8454
Phone
(865) 484-6632
NPI assigned
Mar 28, 2014
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Registered Dietitian 133V00000X LD005117 GA
Registered Dietitian 133V00000X DT86871 TX Primary

Addresses

Primary practice location

9720 Broadway St Apt 216
Pearland, TX 77584-8454

Mailing address

10223 Broadway St Ste P401
Pearland, TX 77584-7880
Phone (658) 484-6632

Other practice location 1

4030 Wake Forest Rd Ste 300
Raleigh, NC 27609-6800
Phone (919) 368-0666

Other practice location 2

2400 Herodian Way SE
#220
Smyrna, GA 30080
Phone (504) 430-3395

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

LicenseStateTypeSpecialty
LD005117GAMDRegistered Dietitian
DT86871TXMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1215354105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST STE P401",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847880",
            "telephone_number": "658-484-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 BROADWAY ST APT 216",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775848454",
            "telephone_number": "865-484-6632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Wake Forest Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276096800",
            "country_code": "US",
            "telephone_number": "919-368-0666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Herodian Way SE",
            "address_2": "#220",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "30080",
            "country_code": "US",
            "telephone_number": "504-430-3395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARIBALDI",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD005117",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.

Verify at the official NPI Registry.