Individual provider Active NPI

Jenica Ferruzzi, MS RDN

  • Registered Dietitian
  • Longmont, CO
National Provider Identifier
1386413029
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86068836 Issued in CO
Practice address
825 Delaware Ave Ste 200
Longmont, CO 80501-6169
Phone
(717) 723-1974
NPI assigned
Dec 21, 2023
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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 86068836 CO Primary

Addresses

Primary practice location

825 Delaware Ave Ste 200
Longmont, CO 80501-6169

Mailing address

903 Terry St
Longmont, CO 80501-4548
Phone (717) 723-1974

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

LicenseStateTypeSpecialty
86068836COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Dynamix, LLC CurrentSince Nov 1, 2024 Accepting new patients
Jenica Ferruzzi Nutrition, LLC Dietitian, Registered CurrentSince Oct 27, 2024 Accepting new patients

Locations

250 Fillmore St
Unit 150
Denver, CO 80206
Phone (410) 505-0521

825 Delaware Ave
Ste 200
Longmont, CO 80501
Phone (720) 252-9415

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1386413029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 TERRY ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805014548",
            "telephone_number": "717-723-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DELAWARE AVE STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016169",
            "telephone_number": "717-723-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRUZZI",
        "first_name": "JENICA",
        "credential": "MS RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86068836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.

Verify at the official NPI Registry.