Individual provider Active NPI

Jessica Anne Reiners

  • Registered Dietitian
  • Saint Paul, MN
National Provider Identifier
1215658075
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4805 Issued in MN
Practice address
2265 Como Ave
Saint Paul, MN 55108-1737
Phone
(651) 645-5323
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 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 4805 MN Primary

Addresses

Primary practice location

2265 Como Ave
Saint Paul, MN 55108-1737

Mailing address

3601 Boardman St
Minneapolis, MN 55417-2144
Phone (262) 748-2398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221025001779 MN Practitioner - Registered Dietitian Or Nutrition Professional 2466828934 Reassigns benefits to 1 organization
I20241211002443 WA Practitioner - Registered Dietitian Or Nutrition Professional 2466828934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince Sep 7, 2022 Accepting new patients
Emily Program PC CurrentSince Dec 9, 2024 Accepting new patients

Locations

2265 Como Ave
Saint Paul, MN 55108

1295 Bandana Blvd N
Ste 210
Saint Paul, MN 55108
Phone (888) 272-0784

673 Woodland Square Loop SE
Ste 330
Olympia, WA 98503
Phone (415) 710-6689

1700 Westlake Ave N
Ste 700
Seattle, WA 98109
Phone (206) 283-2220

2020 E 29th Ave
Ste 200
Spokane, WA 99203
Phone (509) 252-1366

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1215658075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 BOARDMAN ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172144",
            "telephone_number": "262-748-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737",
            "telephone_number": "651-645-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINERS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.