Active NPI
Jennifer Ann Flack, MPH, RDN, LDN, CDE
- Metabolic Nutrition Registered Dietitian
- Athens, AL
National Provider Identifier
1396217360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 2631
- Practice address
- 700 W Market St
Athens, AL 35611-2422 - Phone
- (256) 233-9146
- NPI assigned
- Jan 1, 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 |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 2631 | AL | Primary |
Addresses
Primary practice location
700 W Market St
Athens, AL 35611-2422
Mailing address
700 W Market St
Nutrition & Diabetes Education
Athens, AL 35611
Phone (256) 233-9146
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2631 | AL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546300800000",
"number": "1396217360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W MARKET ST",
"address_2": "NUTRITION & DIABETES EDUCATION",
"city": "ATHENS",
"state": "AL",
"postal_code": "35611",
"telephone_number": "256-233-9146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W MARKET ST",
"city": "ATHENS",
"state": "AL",
"postal_code": "356112422",
"telephone_number": "256-233-9146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLACK",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "MPH, RDN, LDN, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-01",
"last_updated": "2019-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "AL",
"license": "2631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.