Jessica Lynne George, RD LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2308 Issued in MN

Practice address

1200 6TH Avenue North
Centracare Clinic River Campus
St Cloud, MN 56303-2735

Phone

(320) 656-7020

Fax

(320) 255-5714

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica Lynne Dunbar Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1235207481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 NORTH STATE ROAD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4244",
            "fax_number": "320-255-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 6TH AVENUE NORTH",
            "address_2": "CENTRACARE CLINIC RIVER CAMPUS",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-656-7020",
            "fax_number": "320-255-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "credential": "RD LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "887483",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DUNBAR",
            "middle_name": "LYNNE",
            "credential": "RD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Francois Gelin
• Khadra Gelle
• Genoa Healthcare LLC
• Chantelle Lace Genty, RN
• Anna George
• Melissa Mary George
• Stephanie George
• Chelsea Gerads, RN
• Jeffrey S Gerdes, MD
• Terri T Gerdes, MD

• Registered Dietitian in St Cloud, MN
• Providers in St Cloud, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.