Active NPI
Christina Meyer-Jax
- Registered Dietitian
- Chanhassen, MN
National Provider Identifier
1679057640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 866196
- Practice address
- 2665 W 78TH St
Chanhassen, MN 55317-4502 - Phone
- (952) 835-4512
- Fax
- (952) 516-5655
- NPI assigned
- Sep 17, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 866196 | MN | Primary |
Addresses
Primary practice location
2665 W 78TH St
Chanhassen, MN 55317-4502
Mailing address
7825 3Rd St N Ste 105
Oakdale, MN 55128-5444
Phone (125) 092-5026
Other names 1
- Christina Meyer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2018 through Nov 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2092 | MN | MD | Social Worker |
| 866196 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537142400000",
"number": "1679057640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7825 3RD ST N STE 105",
"city": "OAKDALE",
"state": "MN",
"postal_code": "551285444",
"telephone_number": "125-092-5026",
"fax_number": "952-516-5655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2665 W 78TH ST",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553174502",
"telephone_number": "952-835-4512",
"fax_number": "952-516-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER-JAX",
"first_name": "CHRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-17",
"last_updated": "2018-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "866196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINA",
"last_name": "MEYER",
"credential": "RD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chanhassen, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.