Active NPI
Jennifer Brown, MS, RD, LD
- Registered Dietitian
- Benton, KY
National Provider Identifier
1700045929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 307 E 12TH St
Benton, KY 42025-1525 - Phone
- (270) 527-1496
- Fax
- (270) 527-5321
- NPI assigned
- Jun 3, 2008
- 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 | Primary |
Addresses
Primary practice location
307 E 12TH St
Benton, KY 42025-1525
Mailing address
307 E 12TH St
PO Box 607
Benton, KY 42025-1525
Phone (270) 527-1496
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20079018 | Medicaid | KY | |
| 20079026 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080820000543 | KY | Practitioner - Registered Dietitian Or Nutrition Professional | 0446325781 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1551 | KY | MD | Counselor |
Organizations & group practices 1
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": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1700045929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 E 12TH ST",
"address_2": "PO BOX 607",
"city": "BENTON",
"state": "KY",
"postal_code": "420251525",
"telephone_number": "270-527-1496",
"fax_number": "270-527-5321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 E 12TH ST",
"city": "BENTON",
"state": "KY",
"postal_code": "420251525",
"telephone_number": "270-527-1496",
"fax_number": "270-527-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JENNIFER",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20079018",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20079026",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.