Individual provider Active NPI

Jacqueline Cheek, RD, CNSC

  • Registered Dietitian
  • Aurora, CO
National Provider Identifier
1720108368
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND 4905 Issued in FL
Practice address
12401 E 17TH Ave
Aurora, CO 80045-2548
Phone
(386) 341-4410
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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 ND 4905 FL Primary

Addresses

Primary practice location

12401 E 17TH Ave
Aurora, CO 80045-2548

Mailing address

12389 W Atlantic Ave
Lakewood, CO 80228-4478
Phone (386) 341-4410

Other identifiers 1

IdentifierTypeStateIssuer
AF097ZOtherFLMEDICARE

Other names 1

  • Jacqueline K Johnson Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND 4905FLMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1720108368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12389 W ATLANTIC AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284478",
            "telephone_number": "386-341-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452548",
            "telephone_number": "386-341-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEEK",
        "first_name": "JACQUELINE",
        "credential": "RD, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND 4905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AF097Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "JOHNSON",
            "middle_name": "K",
            "credential": "RD,LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.