Active NPI
Jenna Stuart McMillen, RDN
- Registered Dietitian
- Edina, MN
National Provider Identifier
1417719808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5181
- Practice address
- 3250 W 66TH St Apt 548
Edina, MN 55435-5514 - Phone
- (651) 447-6737
- NPI assigned
- Jan 30, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5181 | MN | Primary |
Addresses
Primary practice location
3250 W 66TH St Apt 548
Edina, MN 55435-5514
Mailing address
4470 Illinois St
San Diego, CA 92116-4308
Phone (831) 229-7987
Other practice location 1
609 E Main St
Purcellville, VA 20132-4500
Phone (651) 447-6737
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 |
|---|---|---|---|
| 5181 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley Management LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1417719808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4470 ILLINOIS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921164308",
"telephone_number": "831-229-7987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 W 66TH ST APT 548",
"city": "EDINA",
"state": "MN",
"postal_code": "554355514",
"telephone_number": "651-447-6737"
}
],
"practiceLocations": [
{
"address_1": "609 E Main St",
"address_purpose": "LOCATION",
"city": "Purcellville",
"state": "VA",
"postal_code": "201324500",
"country_code": "US",
"telephone_number": "651-447-6737",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCMILLEN",
"first_name": "JENNA",
"middle_name": "STUART",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "5181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.