Jacqueline Matte Stevens, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI1228 Issued in ME

Practice address

54 Cumberland St Ste 5
Brunswick, ME 04011-1829

Phone

(207) 387-0108

NPI assigned

Dec 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Matte Wainoris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

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  • NPI 1598291478

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1679088637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MUNROE LN",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861229",
            "telephone_number": "207-649-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CUMBERLAND ST STE 5",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040111829",
            "telephone_number": "207-387-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JACQUELINE",
        "middle_name": "MATTE",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WAINORIS",
            "middle_name": "MATTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregory John Stein
• Jason Bryan Steinhouser, D.C.
• Jeffrey Stenzel, M.D.
• Steven H Stern, M.D.
• Gretchen Jane Stevens, LCPC
• Susan R Stewart, LCSW
• Lydia Rose Stilphen
• Calin Stoicov, MD
• Elizabeth Stone, PHD
• Anna K Strange, AU.D.

• Registered Dietitian in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.