Jacquelyn Beth Thym, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1105497

Practice address

PO Box 1510
Hawthorne, NV 89415-1510

Phone

(775) 945-2461

NPI assigned

May 18, 2017

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1770010985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 KIRMAN AVE",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "HAWTHORNE",
            "state": "NV",
            "postal_code": "894151510",
            "telephone_number": "775-945-2461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897034625",
            "country_code": "US",
            "telephone_number": "775-445-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THYM",
        "first_name": "JACQUELYN",
        "middle_name": "BETH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1105497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA HEALTH ASSOICATION",
            "identifier": "1105497",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hawthorne, NV
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.