Jaclynn J Parham, RD, LDN, CNSC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN005848 Issued in PA

Practice address

111 S Front St
Harrisburg, PA 17101-2010

Phone

(717) 782-5283

Fax

(717) 782-5192

NPI assigned

Sep 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jaclyn J Brennan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1376092494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE #2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-782-5283",
            "fax_number": "717-782-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012010",
            "telephone_number": "717-782-5283",
            "fax_number": "717-782-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "JACLYNN",
        "middle_name": "J",
        "credential": "RD, LDN, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN005848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103229258",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "BRENNAN",
            "middle_name": "J",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marcella J Pare, RD, LDN
• Pedro Parente, PHARM.D., D.M.D.
• Parenthood Homecare LLC
• Parenting & Family Solutions
• Mackenzie Elise Pargeon, D.O.
• Devendra B Parikh, DDS
• Taral Kirankumar Parikh
• Vrajkumar Parikh
• Yogesh B Parikh, D.D.S. P.C.
• Jill M Parisi, LSW

• Registered Dietitian in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.