Individual provider Active NPI

Jennifer Rae Wolfe, RD, CSG, LDN

  • Registered Dietitian
  • Jersey Shore, PA
National Provider Identifier
1639844590
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN004607 Issued in PA
Practice address
1020 Thompson St
Jersey Shore, PA 17740-1729
Phone
(570) 398-5142
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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 DN004607 PA Primary

Addresses

Primary practice location

1020 Thompson St
Jersey Shore, PA 17740-1729

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

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

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1639844590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 THOMPSON ST",
            "city": "JERSEY SHORE",
            "state": "PA",
            "postal_code": "177401729",
            "telephone_number": "570-398-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "RD, CSG, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey Shore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.

Verify at the official NPI Registry.