Active NPI
Juan Diego Salcedo, MS, RD
- Registered Dietitian
- Jacksonville, FL
National Provider Identifier
1639981012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 11659
- Practice address
- 4850 Seascape Way Apt 204
Jacksonville, FL 32224-0625 - Phone
- (386) 627-3472
- NPI assigned
- Jan 23, 2025
- Last updated
- Jan 23, 2025
- Sex
- Male
- 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 | 11659 | FL | Primary |
Addresses
Primary practice location
4850 Seascape Way Apt 204
Jacksonville, FL 32224-0625
Mailing address
4850 Seascape Way Apt 204
Jacksonville, FL 32224-0625
Phone (386) 627-3472
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11659 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1639981012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 SEASCAPE WAY APT 204",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240625",
"telephone_number": "386-627-3472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4850 SEASCAPE WAY APT 204",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240625",
"telephone_number": "386-627-3472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALCEDO",
"first_name": "JUAN",
"middle_name": "DIEGO",
"name_prefix": "Mr.",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-23",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "11659",
"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 Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.