Individual provider Active NPI

Jessica Claire Funchion, RD

  • Registered Dietitian
  • Bala Cynwyd, PA
National Provider Identifier
1710430251
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86053365 Issued in PA
Practice address
150 Monument Rd
Ste 207
Bala Cynwyd, PA 19004-1702
Phone
(800) 203-8657
Fax
(800) 258-1426
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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 86053365 PA Primary

Addresses

Primary practice location

150 Monument Rd
Ste 207
Bala Cynwyd, PA 19004-1702

Mailing address

150 Monument Rd
Ste 207
Bala Cynwyd, PA 19004-1702
Phone (800) 203-8657

Other names 1

  • Jessica Claire Fritton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170131001222 NJ Practitioner - Registered Dietitian Or Nutrition Professional 6709168545 Reassigns benefits to 1 organization
I20211026003569 PA Practitioner - Registered Dietitian Or Nutrition Professional 6709168545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86053365PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Plant the Seed Nutrition LLC Dietitian, Registered CurrentSince Jul 8, 2021 Accepting new patients
Virtua Medical Group, PA CurrentSince Dec 5, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Dec 5, 2016 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

Organizations & group practices 3

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1710430251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "800-203-8657",
            "fax_number": "800-258-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MONUMENT RD",
            "address_2": "STE 207",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041702",
            "telephone_number": "800-203-8657",
            "fax_number": "800-258-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNCHION",
        "first_name": "JESSICA",
        "middle_name": "CLAIRE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "86053365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FRITTON",
            "middle_name": "CLAIRE",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.