Individual provider Active NPI

Jessica Masserano, LDN

  • Registered Dietitian
  • Plano, TX
National Provider Identifier
1619451853
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT85466
Practice address
400 Chisholm PL Ste 100
Plano, TX 75075-6911
Phone
(972) 422-9180
Fax
(847) 859-5885
NPI assigned
Sep 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 DT85466 Primary

Addresses

Primary practice location

400 Chisholm PL Ste 100
Plano, TX 75075-6911

Mailing address

400 Chisholm PL Ste 100
Plano, TX 75075-6911
Phone (972) 422-9180

Other names 1

  • Jessi Masserano Professional name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Behavioral Health, PLLC CurrentSince Feb 14, 2023 Accepting new patients
Keepcare LLC Dietitian, Registered Past Accepting new patients

Locations

11551 Forest Central Dr
Ste 202
Dallas, TX 75243
Phone (817) 751-7802

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1619451853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CHISHOLM PL STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756911",
            "telephone_number": "972-422-9180",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CHISHOLM PL STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756911",
            "telephone_number": "972-422-9180",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSERANO",
        "first_name": "JESSICA",
        "credential": "LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "DT85466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSI",
            "last_name": "MASSERANO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.