Active NPI
Jenna R Porter, RD
- Registered Dietitian
- Duluth, MN
National Provider Identifier
1629744404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4547
- Practice address
- 915 E 1St St
Duluth, MN 55805-2107 - Phone
- (218) 249-5555
- NPI assigned
- Aug 20, 2021
- 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 | 4547 | MN | Primary |
Addresses
Primary practice location
915 E 1St St
Duluth, MN 55805-2107
Mailing address
915 E 1St St
Duluth, MN 55805-2107
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@slk.direct.slhduluth.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4547 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Luke'S Hospital of Duluth | Current | Accepting new patients | |
| St. Luke'S Hospital of Duluth | Current | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860
915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352
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.
-
- Clinic/Center
- Duluth, MN
- NPI 1275005498
-
- Rehabilitation Hospital Unit
- Duluth, MN
- NPI 1902845068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1629744404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 E 1ST ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 E 1ST ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558052107",
"telephone_number": "218-249-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JENNA",
"middle_name": "R",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "4547",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@slk.direct.slhduluth.com",
"affiliation": "N",
"address_1": "915 E 1st St",
"city": "Duluth",
"state": "MN",
"country_code": "US",
"postal_code": "558052107",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.