Individual provider Active NPI

Jennifer Lynn Gangale, RD, LD

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Lakewood, OH
National Provider Identifier
1386551364
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
License
851901 Issued in OH
Practice address
12900 Lake Ave Apt 1107
Lakewood, OH 44107-1552
Phone
(440) 474-3562
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity and Weight Management Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133VN1201X 851901 OH Primary

Addresses

Primary practice location

12900 Lake Ave Apt 1107
Lakewood, OH 44107-1552

Mailing address

12900 Lake Ave Apt 1107
Lakewood, OH 44107-1552
Phone (440) 474-3562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1386551364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 LAKE AVE APT 1107",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071552",
            "telephone_number": "440-474-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 LAKE AVE APT 1107",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071552",
            "telephone_number": "440-474-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGALE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "OH",
            "license": "851901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.