Individual provider Active NPI

Jena Camille Eastman, RD, LD

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1467040717
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT86784 Issued in TX
Practice address
5900 Balcones Dr Ste 8477
Austin, TX 78731-4257
Phone
(512) 763-5141
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT86784 TX Primary

Addresses

Primary practice location

5900 Balcones Dr Ste 8477
Austin, TX 78731-4257

Mailing address

5900 Balcones Dr Ste 8477
Austin, TX 78731-4257
Phone (512) 763-5141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220223000002 TX Practitioner - Registered Dietitian Or Nutrition Professional 9537553227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5900 Balcones Dr
Austin, TX 78731-4257
Phone (512) 669-5451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Ally LLC Dietitian, Registered CurrentSince Dec 1, 2023 Accepting new patients

Locations

5900 Balcones Dr
Ste 8477
Austin, TX 78731
Phone (512) 669-5451

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1467040717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 8477",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "512-763-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 8477",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314257",
            "telephone_number": "512-763-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "JENA",
        "middle_name": "CAMILLE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT86784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.

Verify at the official NPI Registry.