Jennifer L Vargas, RD
Individual provider Active NPI Registered Dietitian · Grottoes, VA
NPI 1619751237 · NPPES record last updated Apr 16, 2024
Key facts
- NPI
- 1619751237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DX3568 (MD)
- Practice address
- PO Box 1055
Grottoes, VA 24441-1055 - Phone
- (401) 480-6963
- NPI assigned
- Aug 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI200001391 | DC | MD | Registered Dietitian |
| ND10169 | FL | MD | Registered Dietitian |
| 164009400 | IL | MD | Registered Dietitian |
| DX3568 | MD | MD | Registered Dietitian |
| DN006621 | PA | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN006621 | PA | |
| Registered Dietitian | 133V00000X | ND10169 | FL | |
| Registered Dietitian | 133V00000X | DX3568 | MD | Yes |
| Registered Dietitian | 133V00000X | DI200001391 | DC | |
| Registered Dietitian | 133V00000X | 164009400 | IL |
Addresses
Primary practice location
PO Box 1055
Grottoes, VA 24441-1055
Mailing address
1217 Flatt LN
Grottoes, VA 24441-2420
Phone (401) 480-6963
Other providers in Grottoes, VA
- South River Medical Clinic, LLC
- Angeline Stout
- Sheri A Tratnack
- Valley Pharmacies Inc
- Valley Pharmacies Inc
- Wellness and Action Integration, LLC
All providers in Grottoes, VA · Registered Dietitian in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.