Active NPI
Jacquelyn Jo Nielsen, MS, RD, CDE
- Registered Dietitian
- Fort Collins, CO
National Provider Identifier
1770569667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 708546
- Practice address
- 1101 Oakridge Drive
Suite B
Fort Collins, CO 80525 - Phone
- (970) 622-9997
- Fax
- (970) 667-8383
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 | 708546 | CO | Primary |
Addresses
Primary practice location
1101 Oakridge Drive
Suite B
Fort Collins, CO 80525
Mailing address
1907 Hillrose Drive
Loveland, CO 80538
Phone (970) 622-9997
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00241054 | Other | CO | RAILROAD MEDICARE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 708546 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Nel LLC | Past | Accepting new patients | |
| Partners in Nutrition, LLC | Past | Accepting new patients | |
| Peters Pediatric Speech Therapy LLC | Past | Accepting new patients |
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.
-
- Health Service Clinic/Center
- Fort Collins, CO
- NPI 1710350012
-
- Speech-Language Pathologist
- Loveland, CO
- NPI 1275513061
-
- Hearing and Speech Clinic/Center
- Loveland, CO
- NPI 1780637686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1770569667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 HILLROSE DRIVE",
"city": "LOVELAND",
"state": "CO",
"postal_code": "80538",
"telephone_number": "970-622-9997",
"fax_number": "970-667-8383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 OAKRIDGE DRIVE",
"address_2": "SUITE B",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "80525",
"telephone_number": "970-622-9997",
"fax_number": "970-667-8383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "JACQUELYN",
"middle_name": "JO",
"credential": "MS, RD, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-21",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CO",
"license": "708546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00241054",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.