Individual provider Active NPI

Jennifer Kelsey Smith, MS, RDN, LD

  • Registered Dietitian
  • Atlanta, GA
National Provider Identifier
1477050474
Registry record updated Apr 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD004328 Issued in GA
Practice address
1920 Briarcliff Rd NE
Atlanta, GA 30329-4010
Phone
(404) 785-9350
NPI assigned
Apr 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2018

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 LD004328 GA Primary

Addresses

Primary practice location

1920 Briarcliff Rd NE
Atlanta, GA 30329-4010

Mailing address

821 Druid Oaks NE
Atlanta, GA 30329-3266
Phone (678) 908-8018

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LD004328GAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523059200000",
    "number": "1477050474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 DRUID OAKS NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293266",
            "telephone_number": "678-908-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 BRIARCLIFF RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294010",
            "telephone_number": "404-785-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "KELSEY",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2018-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.

Verify at the official NPI Registry.