Active NPI
Sir Benjomyne Jaimes Jackson, RDN
- Registered Dietitian
- Spring Hill, FL
National Provider Identifier
1467923680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND8653
- Practice address
- 10461 Quality Dr
Spring Hill, FL 34609-9634 - Phone
- (352) 688-3026
- NPI assigned
- Dec 16, 2018
- Sex
- Male
- 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 | ND8653 | FL | Primary |
Addresses
Primary practice location
10461 Quality Dr
Spring Hill, FL 34609-9634
Mailing address
10461 Quality Dr
Spring Hill, FL 34609-9634
Phone (352) 688-3026
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 |
|---|---|---|---|
| ND8653 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544918400000",
"number": "1467923680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10461 QUALITY DR",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346099634",
"telephone_number": "352-688-3026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10461 QUALITY DR",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346099634",
"telephone_number": "352-688-3026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SIR BENJOMYNE",
"middle_name": "JAIMES",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND8653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.