Joanne Perez-Vergara, RDN. LD/N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LDN8288 Issued in FL

Practice address

2799 Turtle Shores Dr
Fernandina Beach, FL 32034-6645

Phone

(864) 436-7324

NPI assigned

Mar 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1609294552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 TURTLE SHORES DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320346645",
            "telephone_number": "912-443-4200",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 TURTLE SHORES DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320346645",
            "telephone_number": "864-436-7324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Eisenhower Drive",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "31406",
            "country_code": "US",
            "telephone_number": "912-355-9220",
            "fax_number": "912-355-8124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ-VERGARA",
        "first_name": "JOANNE",
        "credential": "RDN. LD/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "LDN8288",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD004223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joy Susan Pendergrass, FNP,BC
• Donald Penny
• Samuel E Perkins Jr., MD
• Heather Peters
• Amelia Phillips, ARNP
• Harvey Gene Phillips Jr., MD
• Physicians Group Services PA

• Registered Dietitian in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.