Active NPI
Jessica S Johnson, MNT
- Registered Dietitian
- Brooksville, FL
National Provider Identifier
1548435183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 898669
- Practice address
- 300 South Main Street
Brooksville, FL 34601-3320 - Phone
- (352) 540-6800
- Fax
- (352) 754-4132
- NPI assigned
- Apr 24, 2008
- 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 | 898669 | IL | Primary |
Addresses
Primary practice location
300 South Main Street
Brooksville, FL 34601-3320
Mailing address
300 South Main Street
Brooksville, FL 34601-3320
Phone (352) 540-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 898669 | Other | IL | CRD |
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 |
|---|---|---|---|
| 898669 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1548435183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SOUTH MAIN STREET",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346013320",
"telephone_number": "352-540-6800",
"fax_number": "352-754-4132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SOUTH MAIN STREET",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346013320",
"telephone_number": "352-540-6800",
"fax_number": "352-754-4132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JESSICA",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "MNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "898669",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRD",
"identifier": "898669",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.