Active NPI
Joyce Premika Bussert, RDN, LDN, MPH
- Registered Dietitian
- Schaumburg, IL
National Provider Identifier
1710433461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164006595
- Practice address
- 650 E Algonquin Rd Ste 108
Schaumburg, IL 60173-3853 - Phone
- (224) 334-2287
- NPI assigned
- Aug 31, 2016
- 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 | 164006595 | IL | Primary |
Addresses
Primary practice location
650 E Algonquin Rd Ste 108
Schaumburg, IL 60173-3853
Mailing address
1307 Wasdale Ave
Elk Grove Village, IL 60007-3928
Phone (224) 334-2287
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164006595 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1710433461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 WASDALE AVE",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073928",
"telephone_number": "224-334-2287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E ALGONQUIN RD STE 108",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601733853",
"telephone_number": "224-334-2287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSSERT",
"first_name": "JOYCE",
"middle_name": "PREMIKA",
"credential": "RDN, LDN, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-31",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164006595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.