Active NPI
Georgia A Janssen, MS RD LDN
- Registered Dietitian
- Quincy, IL
National Provider Identifier
1649272659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164-000168
- Practice address
- 1005 Broadway St
Quincy, IL 62301-2834 - Phone
- (217) 223-8400
- Fax
- (217) 223-9716
- NPI assigned
- Aug 10, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164-000168 | IL | Primary |
| Registered Dietitian | 133V00000X | 2004029301 | MO |
Addresses
Primary practice location
1005 Broadway St
Quincy, IL 62301-2834
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GJ1068001 | Other | IL | AMERICAN SPECIALTY HEALTH |
| 00132009 | Other | IL | BLUE CROSS BLUE SHIELD |
| 075113 | Other | IL | QUINCY HEALTH CARE MGMT. |
| 002410837 | Other | IL | UNITED HEALTH CARE |
Other names 1
- Mrs. Georgia A Schreacke
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164-000168 | IL | MD | Registered Dietitian |
| 2004029301 | MO | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313539200000",
"number": "1649272659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012834",
"telephone_number": "217-223-8400",
"fax_number": "217-223-9716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012834",
"telephone_number": "217-223-8400",
"fax_number": "217-223-9716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSSEN",
"first_name": "GEORGIA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "MS RD LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-10",
"last_updated": "2011-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164-000168",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MO",
"license": "2004029301",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPECIALTY HEALTH",
"identifier": "GJ1068001",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00132009",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUINCY HEALTH CARE MGMT.",
"identifier": "075113",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "002410837",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GEORGIA",
"last_name": "SCHREACKE",
"middle_name": "A",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.