Individual provider Active NPI

Jereme' A Gallier, RD, LD

  • Sports Dietetics Nutrition Registered Dietitian
  • Baltimore, MD
National Provider Identifier
1639814643
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
License
DX5606 Issued in MD
Practice address
1020 Hull St # 1
Baltimore, MD 21230-5356
Phone
(410) 752-0300
NPI assigned
May 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X LD006072 GA
Sports Dietetics Nutrition Registered Dietitian 133VN1501X DX5606 MD Primary

Addresses

Primary practice location

1020 Hull St # 1
Baltimore, MD 21230-5356

Mailing address

1438 Decatur St
Baltimore, MD 21230-5213
Phone (601) 595-0985

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

State licenses

LicenseStateTypeSpecialty
LD006072GAMDSports Dietetics Nutrition Registered Dietitian
DX5606MDMDSports Dietetics Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
JG Performance and Wellness L.L.C. CurrentSince Jun 11, 2023 Accepting new patients
Eastern Maine Healthcare Systems Past Accepting new patients
Fay Nutrition Past Accepting new patients
Nourish, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1639814643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 DECATUR ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305213",
            "telephone_number": "601-595-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HULL ST # 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305356",
            "telephone_number": "410-752-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIER",
        "first_name": "JEREME'",
        "middle_name": "A",
        "credential": "RD,  LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "GA",
            "license": "LD006072",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "MD",
            "license": "DX5606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.