Active NPI
Jill S Struble, RD
- Registered Dietitian
- Gainesville, FL
National Provider Identifier
1407096670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND 5961
- Practice address
- 1601 Archer Road
North Florida / South Georgia Malcom Randall Vamc
Gainesville, FL 32608 - Phone
- (904) 396-8750
- NPI assigned
- Mar 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN003513 | PA | |
| Registered Dietitian | 133V00000X | ND 5961 | FL | Primary |
Addresses
Primary practice location
1601 Archer Road
North Florida / South Georgia Malcom Randall Vamc
Gainesville, FL 32608
Mailing address
4161 Carmichael Ave., Building 3300
VA: HCHV Suite 150
Jacksonville, FL 32207
Phone (904) 396-8750
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 |
|---|---|---|---|
| ND 5961 | FL | MD | Registered Dietitian |
| DN003513 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492992000000",
"number": "1407096670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4161 CARMICHAEL AVE., BUILDING 3300",
"address_2": "VA: HCHV SUITE 150",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32207",
"telephone_number": "904-396-8750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 ARCHER ROAD",
"address_2": "NORTH FLORIDA / SOUTH GEORGIA MALCOM RANDALL VAMC",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "32608",
"telephone_number": "904-396-8750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRUBLE",
"first_name": "JILL",
"middle_name": "S",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-02",
"last_updated": "2017-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003513",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND 5961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.