Individual provider Active NPI

Jennifer Lynn Gregoline, RD

  • Registered Dietitian
  • Indianapolis, IN
National Provider Identifier
1497982490
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
913931 Issued in IN
Practice address
6625 Network Way Ste 100
Intech 11
Indianapolis, IN 46278-0007
Phone
(317) 275-7010
Fax
(317) 275-7012
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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 913931 IN Primary

Addresses

Primary practice location

6625 Network Way Ste 100
Intech 11
Indianapolis, IN 46278-0007

Mailing address

6625 Network Way Ste 100
Intech 11
Indianapolis, IN 46278-0007
Phone (317) 275-7010

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

State licenses

LicenseStateTypeSpecialty
913931INMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Indiana Pathology, PC Past Accepting new patients
Columbus Regional Hospital Inc PastSince Jan 1, 1990 Accepting new patients
Columbus Regional Hospital PastSince Jan 1, 1990 Accepting new patients
Pulaski Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Pulaski Memorial Hospital PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 5

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1497982490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 NETWORK WAY STE 100",
            "address_2": "INTECH 11",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462780007",
            "telephone_number": "317-275-7010",
            "fax_number": "317-275-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 NETWORK WAY STE 100",
            "address_2": "INTECH 11",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462780007",
            "telephone_number": "317-275-7010",
            "fax_number": "317-275-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGOLINE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "913931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.