Active NPI
Jennifer Vick
- Registered Dietitian
- Louisville, KY
National Provider Identifier
1376104562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 123191
- Practice address
- 2355 Poplar Level Rd Ste 301
Louisville, KY 40217-1388 - Phone
- (502) 636-0406
- Fax
- (502) 636-5137
- NPI assigned
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 123191 | KY | Primary |
Addresses
Primary practice location
2355 Poplar Level Rd Ste 301
Louisville, KY 40217-1388
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jennifer.cotita@nortonhealthcare.org | ||
| CONNECT URL | jennifer.cotita@nortonhealthcare.org |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123191 | KY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1376104562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776351",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776351",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 POPLAR LEVEL RD STE 301",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171388",
"telephone_number": "502-636-0406",
"fax_number": "502-636-5137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICK",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "123191",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "jennifer.cotita@nortonhealthcare.org",
"affiliation": "N",
"address_1": "9880 Angies Way Ste 420",
"city": "Louisville",
"state": "KY",
"country_code": "US",
"postal_code": "402412850",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "jennifer.cotita@nortonhealthcare.org",
"affiliation": "N",
"address_1": "9880 Angies Way Ste 420",
"city": "Louisville",
"state": "KY",
"country_code": "US",
"postal_code": "402412850",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.