Active NPI
Gloria B De Jesus, LND,RD
- Registered Dietitian
- Toa Alta, PR
National Provider Identifier
1356594964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1076
- Practice address
- 1062 Calle Egipto
Plaza de la Fuente
Toa Alta, PR 00953-3804 - Phone
- (787) 777-3535
- Fax
- (787) 756-8907
- NPI assigned
- Oct 28, 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 | 1076 | PR | Primary |
Addresses
Primary practice location
1062 Calle Egipto
Plaza de la Fuente
Toa Alta, PR 00953-3804
Mailing address
1062 Calle Egipto
Plaza de la Fuente
Toa Alta, PR 00953-3804
Phone (787) 777-3535
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1076 | PR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1356594964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 CALLE EGIPTO",
"address_2": "PLAZA DE LA FUENTE",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "009533804",
"telephone_number": "787-777-3535",
"fax_number": "787-756-8907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1062 CALLE EGIPTO",
"address_2": "PLAZA DE LA FUENTE",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "009533804",
"telephone_number": "787-777-3535",
"fax_number": "787-756-8907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "GLORIA",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "LND,RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toa Alta, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.