Jennifer L Guptail, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

4272 Issued in MN

Practice address

6401 France Ave S
Edina, MN 55435-2104

Phone

(952) 924-5000

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  NPD

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1255951950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 PINEHURST DR",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174579",
            "telephone_number": "612-719-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTAIL",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "4272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha Abdi Guled
• Elias Faysal Guled
• Jeanette Bradford Gunderson, OTR
• Ronnie M. Gundlach, D.O.
• Kerry Lynch Guntli, PA-C
• Gurganus Psychological Services, LLC
• Kimberly Lynn Gustafson, OT
• Maxine Rae Gustafson, PA-C
• Heidi Gustavson
• Maryan Gutale

• Registered Dietitian in Edina, MN
• Providers in Edina, MN by specialty
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.