Individual provider Active NPI

Jenna Elizabeth Stern, RD

  • Registered Dietitian
  • Glendale, AZ
National Provider Identifier
1376807552
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86004226 Issued in AZ
Practice address
5130 W Thunderbird Rd
Suites 1 & 3
Glendale, AZ 85306-4879
Phone
(602) 439-9000
Fax
(602) 978-5233
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86004226 AZ Primary

Addresses

Primary practice location

5130 W Thunderbird Rd
Suites 1 & 3
Glendale, AZ 85306-4879

Mailing address

5130 W Thunderbird Rd
Suites 1 & 3
Glendale, AZ 85306-4879
Phone (602) 439-9000

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

State licenses

LicenseStateTypeSpecialty
86004226AZMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1376807552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 W THUNDERBIRD RD",
            "address_2": "SUITES 1 & 3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064879",
            "telephone_number": "602-439-9000",
            "fax_number": "602-978-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 W THUNDERBIRD RD",
            "address_2": "SUITES 1 & 3",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064879",
            "telephone_number": "602-439-9000",
            "fax_number": "602-978-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JENNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86004226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.