Active NPI
Theresa Reynolds, RDN, LD
- Registered Dietitian
- Juneau, AK
National Provider Identifier
1609463868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 152559
- Practice address
- 4237 Riverside Dr
Juneau, AK 99801-8973 - Phone
- (703) 415-6090
- NPI assigned
- Dec 22, 2020
- 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 | 152559 | AK | Primary |
Addresses
Primary practice location
4237 Riverside Dr
Juneau, AK 99801-8973
Mailing address
4237 Riverside Dr
Juneau, AK 99801-8973
Phone (703) 415-6090
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1609463868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4237 RIVERSIDE DR",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998018973",
"telephone_number": "703-415-6090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4237 RIVERSIDE DR",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998018973",
"telephone_number": "703-415-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "THERESA",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-22",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AK",
"license": "152559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Juneau, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.