Active NPI
Vanessa Joana Rojas-Bautista, R.D.N.
- Renal Nutrition Registered Dietitian
- Star, ID
National Provider Identifier
1417328121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Nutrition Registered Dietitian
- License
- 1096678
- Practice address
- 680 S Calhoun PL
Star, ID 83669-5310 - Phone
- (208) 353-1528
- NPI assigned
- Oct 8, 2015
- Last updated
- Aug 8, 2026
- 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 |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 1096678 | CA | Primary |
Addresses
Primary practice location
680 S Calhoun PL
Star, ID 83669-5310
Mailing address
680 S Calhoun PL
Star, ID 83669-5310
Phone (208) 599-0341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
317 6TH Ave
Suite 400
Des Moines, IA 50309-4037
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1096678 | CA | MD | Renal Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Past | Accepting new patients | |
| Nutrithrive LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Registered Dietitian
- Star, ID
- NPI 1841115003
-
- Registered Dietitian
- San Francisco, CA
- NPI 1104334465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786147200000",
"number": "1417328121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 S CALHOUN PL",
"city": "STAR",
"state": "ID",
"postal_code": "836695310",
"telephone_number": "208-599-0341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 S CALHOUN PL",
"city": "STAR",
"state": "ID",
"postal_code": "836695310",
"telephone_number": "208-353-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROJAS-BAUTISTA",
"first_name": "VANESSA",
"middle_name": "JOANA",
"credential": "R.D.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2026-08-08",
"certification_date": "2026-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "CA",
"license": "1096678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Star, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.