Active NPI
Jacqlyn Marie Gluck, MS, RDN
- Registered Dietitian
- Onamia, MN
National Provider Identifier
1497344295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4478
- Practice address
- 18562 Minobimaadizi Loop
Onamia, MN 56359-3001 - Phone
- (320) 290-9526
- NPI assigned
- Jan 15, 2021
- Last updated
- May 19, 2022
- 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 | 4478 | MN | Primary |
Addresses
Primary practice location
18562 Minobimaadizi Loop
Onamia, MN 56359-3001
Mailing address
18562 Minobimaadizi Loop
Onamia, MN 56359-3001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
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
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Burlington, VT 05401
Phone (802) 222-6907
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| No Diet Dietitian, LLC | Dietitian, Registered | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1497344295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18562 MINOBIMAADIZI LOOP",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563593001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18562 MINOBIMAADIZI LOOP",
"city": "ONAMIA",
"state": "MN",
"postal_code": "563593001",
"telephone_number": "320-290-9526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLUCK",
"first_name": "JACQLYN",
"middle_name": "MARIE",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-15",
"last_updated": "2022-05-19",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "4478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onamia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.