Individual provider Active NPI

Jessica Elizabeth Jennings, R.D.

  • Registered Dietitian
  • Black River Falls, WI
National Provider Identifier
1275883258
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405
Phone
(888) 685-4422
Fax
(715) 284-5107
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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 Primary

Addresses

Primary practice location

N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405

Mailing address

N6520 Lumberjack Guy Rd
Black River Falls, WI 54615-5405
Phone (888) 685-4422

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
2550WIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1275883258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6520 LUMBERJACK GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "888-685-4422",
            "fax_number": "715-284-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6520 LUMBERJACK GUY RD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155405",
            "telephone_number": "888-685-4422",
            "fax_number": "715-284-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.