Jessy Brinling Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

JESSY BRINLING NUTRITION LLC

Doing business as

Great Lakes Nutrition

Practice address

3910 Caughey Rd Ste 200
Erie, PA 16506-4098

Phone

(814) 580-8808

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Jessica Elaine Lake, MS, RDN, LDNPI 1154910214

Title

Registered Dietitian

Phone

(814) 580-8808

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Nutrition Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Elaine Lake, MS, RDN, LD

  • Registered Dietitian
  • Erie, PA
  • NPI 1154910214

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1669234381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 CAUGHEY RD STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064098",
            "telephone_number": "814-580-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CAUGHEY RD STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064098",
            "telephone_number": "814-580-8808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9345 Lake Pleasant Rd",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165095755",
            "country_code": "US",
            "telephone_number": "814-460-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JESSY BRINLING NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "814-580-8808",
        "authorized_official_credential": "MS, RDN, LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Nutrition",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Marie Jensen
• Nicklas Jensen
• Sarah Elizabeth Jeremiah, M.D.
• Jerome L. Troncone, Psy.PC
• Jessica B. Macrino, LPC, LLC
• Jill D Cuthbertson, OD, PC
• Paul Mishel Jimenez Stuart, DO
• Robert Jude Joba, O.D.
• Holly Kay Jodon, PA-C
• Jagdeep Johal, DO

• Registered Dietitian in Erie, PA
• Providers in Erie, PA by specialty
• Registered Dietitian in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.