Active NPI
Jennifer Dorothy Reardon, MS, RDN, CDN
- Registered Dietitian
- Batavia, NY
National Provider Identifier
1518239961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 005323-1
- Practice address
- 47A Batavia City Ctr
Batavia, NY 14020-2107 - Phone
- (716) 830-4160
- NPI assigned
- Feb 1, 2012
- Last updated
- Apr 8, 2014
- 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 | 005323-1 | NY | Primary |
Addresses
Primary practice location
47A Batavia City Ctr
Batavia, NY 14020-2107
Mailing address
21 Washington Ave
Batavia, NY 14020-2037
Phone (716) 830-4160
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005323-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396915200000",
"number": "1518239961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WASHINGTON AVE",
"city": "BATAVIA",
"state": "NY",
"postal_code": "140202037",
"telephone_number": "716-830-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47A BATAVIA CITY CTR",
"city": "BATAVIA",
"state": "NY",
"postal_code": "140202107",
"telephone_number": "716-830-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "JENNIFER",
"middle_name": "DOROTHY",
"name_prefix": "Ms.",
"credential": "MS, RDN, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-01",
"last_updated": "2014-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "005323-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Batavia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.