Individual provider Active NPI

Calli Lizabeth Brubeck, RDN

  • Registered Dietitian
  • Jacksonville Beach, FL
National Provider Identifier
1285578211
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
11285 Issued in FL
Practice address
2400 1St St S Unit I36
Jacksonville Beach, FL 32250-8019
Phone
(904) 955-5871
NPI assigned
Apr 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2026

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 11285 FL Primary

Addresses

Primary practice location

2400 1St St S Unit I36
Jacksonville Beach, FL 32250-8019

Mailing address

2400 1St St S Unit I36
Jacksonville Beach, FL 32250-8019
Phone (904) 955-5871

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

State licenses

LicenseStateTypeSpecialty
11285FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1776470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776470400000",
    "number": "1285578211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 1ST ST S UNIT I36",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322508019",
            "telephone_number": "904-955-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 1ST ST S UNIT I36",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322508019",
            "telephone_number": "904-955-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBECK",
        "first_name": "CALLI",
        "middle_name": "LIZABETH",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-18",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "11285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2026; 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.