Jeanne Farrell, RD, CNSC

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

ND1271 Issued in FL

Practice address

501 6TH Ave S
St Petersburg, FL 33701-4634

Phone

(727) 767-8419

NPI assigned

Oct 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1306249578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 TIDAL LN APT 104",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342124446",
            "telephone_number": "727-767-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "JEANNE",
        "credential": "RD, CNSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "ND1271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "652804",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Farley
• Paul Joseph Farnsworth, D.O.
• Amaya Farr, MD
• Betty Farr, LMHC
• Sarah Toggweiler Farr, DNP, APRN, FNP-C
• Melissa Ann Farrell, LCSW
• Karen Marie Farris, M.D.
• Danielle N Fasciano, DO
• Avery Jane Fasulo
• Delaram Fatemi, MD

• All providers in St Petersburg, FL
• Pediatric Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.