Individual provider Active NPI

Jenna Bishop, RD, LDN

  • Registered Dietitian
  • Hendersonville, TN
National Provider Identifier
1518328665
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4791 Issued in TN
Practice address
355 New Shackle Island Rd Ste 128B
Hendersonville, TN 37075-2479
Phone
(615) 492-6116
Fax
(615) 334-8962
NPI assigned
Mar 17, 2016
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 4791 TN Primary
Registered Dietitian 133V00000X 164005610 IL

Addresses

Primary practice location

355 New Shackle Island Rd Ste 128B
Hendersonville, TN 37075-2479

Mailing address

3127 W Chadwick LN
Peoria, IL 61614-1018
Phone (309) 713-6502

Other practice location 1

600 NE Water Street
Peoria, IL 61637
Phone (309) 282-1600

Other identifiers 1

IdentifierTypeStateIssuer
164005610OtherILRD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250115000357 TN Practitioner - Registered Dietitian Or Nutrition Professional 5294263596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tennessee Style Weight Loss LLCGroup PAC ID 1951750595, 5 clinicians

Practice addresses (Care Compare)

355 New Shackle Island Rd
Suite 128B
Hendersonville, TN 37075-2399
Phone (615) 492-6116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164005610ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Style Weight Loss LLC Dietitian, Registered CurrentSince Nov 1, 2024 Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

355 New Shackle Island Rd
Ste 128B
Hendersonvlle, TN 37075
Phone (309) 229-4338

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, 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": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1518328665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 W CHADWICK LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141018",
            "telephone_number": "309-713-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NEW SHACKLE ISLAND RD STE 128B",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752479",
            "telephone_number": "615-492-6116",
            "fax_number": "615-334-8962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 NE Water Street",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "61637",
            "country_code": "US",
            "telephone_number": "309-282-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "JENNA",
        "name_prefix": "Mrs.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "4791",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD LICENSE",
            "identifier": "164005610",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.

Verify at the official NPI Registry.