Active NPI
Jennifer M Pas, R.D., L.D.
- Registered Dietitian
- Albuquerque, NM
National Provider Identifier
1356385751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 362
- Practice address
- 4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681 - Phone
- (505) 332-8070
- NPI assigned
- Jun 15, 2006
- 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 | 362 | NM | Primary |
Addresses
Primary practice location
4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681
Mailing address
4425 Juan Tabo Blvd NE
Albuquerque, NM 87111-2681
Phone (505) 332-8070
Other names 1
- Jennifer M. Gilmore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM, TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070127000098 | NM | Practitioner - Registered Dietitian Or Nutrition Professional | 7911959275 | Reassigns benefits to 2 organizations |
| I20210915001222 | TX | Practitioner - Registered Dietitian Or Nutrition Professional | 7911959275 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 362 | NM | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehoboth McKinley Christian Health Care Services, Inc. | Current | Accepting new patients | |
| Canoncito Band of Navajos Health Center, Inc | Current | Accepting new patients | |
| Rehoboth McKinley Christian Health Care Services, Inc | Current | Accepting new patients | |
| Rehoboth McKinley Christian Health Care Services, Inc | Current | Accepting new patients | |
| Canoncito Band of Navajos Health Center, Inc. | Current | Accepting new patients | |
| Global Nutrition Services, LLC | Dietitian, Registered | Past | Accepting new patients |
| Deming Hospital Corporation | Past | Accepting new patients |
Locations
1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000
129 Medicine Horse Dr
Tohajiilee, NM 87026
Phone (505) 908-2307
Organizations & group practices 7
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.
-
- Rural Health Clinic/Center
- Tohajiilee, NM
- NPI 1578010070
TX
-
- Critical Access Hospital
- Gallup, NM
- NPI 1689784506
NM
-
- Critical Access Hospital
- Gallup, NM
- NPI 1720084999
NM
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Canoncito, NM
- NPI 1629525605
-
- Rural Health Clinic/Center
- Gallup, NM
- NPI 1689779860
-
- Pain Medicine (Anesthesiology) Physician
- Deming, NM
- NPI 1386850519
-
- Registered Dietitian
- Albuquerque, NM
- NPI 1548427826
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1356385751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 JUAN TABO BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112681",
"telephone_number": "505-332-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 JUAN TABO BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871112681",
"telephone_number": "505-332-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAS",
"first_name": "JENNIFER",
"middle_name": "M",
"credential": "R.D., L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NM",
"license": "362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "GILMORE",
"middle_name": "M.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.