Individual provider Active NPI

Jennifer L Berdinka

  • Registered Dietitian
  • Bellingham, WA
National Provider Identifier
1649428434
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00001661 Issued in WA
Practice address
2901 Squalicum Parkway
Bellingham, WA 98225
Phone
(360) 734-5400
Fax
(360) 756-3552
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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 DI00001661 WA Primary

Addresses

Primary practice location

2901 Squalicum Parkway
Bellingham, WA 98225

Mailing address

2901 Squalicum Parkway
Bellingham, WA 98225
Phone (360) 734-5400

Other identifiers 1

IdentifierTypeStateIssuer
DI00001661OtherWAWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121109000106 WA Practitioner - Registered Dietitian Or Nutrition Professional 1557512035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12 Bellwether Way
Suite 223
Bellingham, WA 98225-2914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI00001661WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Aug 1, 2012 Accepting new patients
Peacehealth Past Accepting new patients
Peacehealth Dietitian, Registered Past Accepting new patients

Locations

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

4465 Cordata Pkwy
Ste B
Bellingham, WA 98226
Phone (360) 752-5206

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

4545 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5646

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1649428434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SQUALICUM PARKWAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-734-5400",
            "fax_number": "360-756-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SQUALICUM PARKWAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-734-5400",
            "fax_number": "360-756-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDINKA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "DI00001661",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.