Active NPI
Jaclyn Jozefiak, RDN, MS
- Registered Dietitian
- Kenosha, WI
National Provider Identifier
1497412126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86169787
- Practice address
- 6838 93Rd CT
Kenosha, WI 53142-8104 - Phone
- (262) 909-9282
- NPI assigned
- Nov 17, 2021
- Sex
- Female
- 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 | 86169787 | WI | Primary |
Addresses
Primary practice location
6838 93Rd CT
Kenosha, WI 53142-8104
Mailing address
6838 93Rd CT
Kenosha, WI 53142-8104
Phone (262) 909-9282
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86169787 | WI | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unmeasured Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Piece of Nutrition, LLC | 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.
-
- Health Service Clinic/Center
- Chicago, IL
- NPI 1699350207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1497412126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6838 93RD CT",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531428104",
"telephone_number": "262-909-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6838 93RD CT",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531428104",
"telephone_number": "262-909-9282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOZEFIAK",
"first_name": "JACLYN",
"credential": "RDN, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-17",
"last_updated": "2021-11-17",
"certification_date": "2021-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "86169787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.