Active NPI
Janelle C Eligon-Ketchum, LDN
- Registered Dietitian
- Philadelphia, PA
National Provider Identifier
1295986255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN003937
- Practice address
- 2501 W Lehigh Ave
Philadelphia, PA 19132-3207 - Phone
- (215) 227-0300
- Fax
- (215) 227-0302
- NPI assigned
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- No
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 | DN003937 | PA | Primary |
Addresses
Primary practice location
2501 W Lehigh Ave
Philadelphia, PA 19132-3207
Mailing address
2501 W Lehigh Ave
Philadelphia, PA 19132-3207
Phone (215) 227-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1512 S St
Philadelphia, PA 19146-1636
Phone (267) 239-5637
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Unlimited | Dietitian, Registered | Current | Accepting new patients |
Locations
1512 South St
Philadelphia, PA 19146
Phone (267) 239-5637
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": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1295986255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 W LEHIGH AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191323207",
"telephone_number": "215-227-0300",
"fax_number": "215-227-0302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 W LEHIGH AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191323207",
"telephone_number": "215-227-0300",
"fax_number": "215-227-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIGON-KETCHUM",
"first_name": "JANELLE",
"middle_name": "C",
"credential": "LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.