Active NPI
Jessica Lynn Martini, MS RDN
- Registered Dietitian
- Portland, OR
National Provider Identifier
1275038234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD-D-000864
- Practice address
- 4524 SE 36TH PL
Portland, OR 97202-3223 - Phone
- (503) 577-9189
- Fax
- (503) 577-9189
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD-D-000864 | OR | Primary |
Addresses
Primary practice location
4524 SE 36TH PL
Portland, OR 97202-3223
Mailing address
4524 SE 36TH PL
Portland, OR 97202-3223
Phone (503) 577-9189
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD-D-000864 | OR | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1275038234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4524 SE 36TH PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972023223",
"telephone_number": "503-577-9189",
"fax_number": "503-577-9189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4524 SE 36TH PL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972023223",
"telephone_number": "503-577-9189",
"fax_number": "503-577-9189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINI",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "MS RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "LD-D-000864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.