Active NPI
Jenna Elizabeth Fadale
- Registered Dietitian
- Honesdale, PA
National Provider Identifier
1467090712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 952 Bethany Tpke
Honesdale, PA 18431-4194 - Phone
- (716) 949-0006
- NPI assigned
- Dec 17, 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
952 Bethany Tpke
Honesdale, PA 18431-4194
Mailing address
952 Bethany Tpke
Honesdale, PA 18431-4194
Phone (716) 949-0006
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
| Allara Medical Group PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Gynecology Physician
- New York, NY
- NPI 1700450558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1467090712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "952 BETHANY TPKE",
"city": "HONESDALE",
"state": "PA",
"postal_code": "184314194",
"telephone_number": "716-949-0006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "952 BETHANY TPKE",
"city": "HONESDALE",
"state": "PA",
"postal_code": "184314194",
"telephone_number": "716-949-0006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADALE",
"first_name": "JENNA",
"middle_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-17",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honesdale, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.