Active NPI
Jill Woodruff King
- Registered Dietitian
- Virginia Beach, VA
National Provider Identifier
1508364928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1045075
- Practice address
- 1080 First Colonial Rd Ste 200
Virginia Beach, VA 23454-2406 - Phone
- (757) 395-6603
- NPI assigned
- Jan 31, 2018
- 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 | 1045075 | VA | Primary |
Addresses
Primary practice location
1080 First Colonial Rd Ste 200
Virginia Beach, VA 23454-2406
Mailing address
469 Goodspeed Rd
Virginia Beach, VA 23451-2206
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1045075 | VA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517356800000",
"number": "1508364928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "469 GOODSPEED RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234512206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1080 FIRST COLONIAL RD STE 200",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542406",
"telephone_number": "757-395-6603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JILL",
"middle_name": "WOODRUFF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-31",
"last_updated": "2018-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "VA",
"license": "1045075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.