Individual provider Active NPI

Jaclyn Bart, RD

  • Registered Dietitian
  • Scottsdale, AZ
National Provider Identifier
1548652779
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1079590 Issued in AZ
Practice address
8415 N Pima Rd
Suite 150
Scottsdale, AZ 85258-4480
Phone
(480) 551-1057
Fax
(480) 551-1059
NPI assigned
Feb 25, 2015
Last updated
Aug 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 1079590 AZ Primary

Addresses

Primary practice location

8415 N Pima Rd
Suite 150
Scottsdale, AZ 85258-4480

Mailing address

3333 E Camelback Rd
Suite 180
Phoenix, AZ 85018-2322
Phone (602) 997-0484

Other identifiers 1

IdentifierTypeStateIssuer
989536MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150327001728 AZ Practitioner - Registered Dietitian Or Nutrition Professional 4082931290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alexander Solutions LLCGroup PAC ID 8224370457, 11 clinicians

Practice addresses (Care Compare)

2929 N Power Rd
Suite 101
Mesa, AZ 85215-1746
Phone (480) 266-4122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1079590AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Red Mountain Dietitian Services LLC Dietitian, Registered CurrentSince Sep 1, 2024 Accepting new patients
Alexander Solutions LLC Dietitian, Registered CurrentSince Sep 1, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Locations

2373 E Baseline Rd
Ste 102
Gilbert, AZ 85234
Phone (480) 266-4122

2929 N Power Rd
Mesa, AZ 85215
Phone (480) 266-4122

2929 N Power Rd
Ste 101
Mesa, AZ 85215
Phone (480) 266-4122

1050 E Southern Ave
Ste F3
Tempe, AZ 85282
Phone (480) 266-4122

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1548652779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD",
            "address_2": "SUITE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182322",
            "telephone_number": "602-997-0484",
            "fax_number": "602-224-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 N PIMA RD",
            "address_2": "SUITE 150",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584480",
            "telephone_number": "480-551-1057",
            "fax_number": "480-551-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BART",
        "first_name": "JACLYN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1079590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "989536",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.