Active NPI
Jennie Lauren Butler, PHD, RDN, LDN
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1619458080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 8749
- Practice address
- 1900 Corporate Square Blvd
Jacksonville, FL 32216-1941 - Phone
- (919) 951-4345
- NPI assigned
- Aug 23, 2018
- 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 | 8749 | FL | Primary |
Addresses
Primary practice location
1900 Corporate Square Blvd
Jacksonville, FL 32216-1941
Mailing address
78 W 11TH St
Atlantic Beach, FL 32233-3461
Phone (919) 951-4345
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8749 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Combined Nutrition Solutions LLC | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Registered Dietitian
- Jacksonville, FL
- NPI 1578136032
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626912000000",
"number": "1619458080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 W 11TH ST",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "322333461",
"telephone_number": "919-951-4345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 CORPORATE SQUARE BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161941",
"telephone_number": "919-951-4345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTLER",
"first_name": "JENNIE",
"middle_name": "LAUREN",
"name_prefix": "Dr.",
"credential": "PHD, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-23",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "8749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.