Jennifer Keller Smith, RD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

37001254A Issued in IN

Practice address

1600 Albany St
Beech Grove, IN 46107-1541

Phone

(317) 851-3841

Fax

(317) 865-5083

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Susan Keller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1770705899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7164 BRACKEN LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462397838",
            "telephone_number": "317-851-3841",
            "fax_number": "317-865-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ALBANY ST",
            "city": "BEECH GROVE",
            "state": "IN",
            "postal_code": "461071541",
            "telephone_number": "317-851-3841",
            "fax_number": "317-865-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "KELLER",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IN",
            "license": "37001254A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KELLER",
            "middle_name": "SUSAN",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phoebe Shackelford, PHARMD
• Nalin M Shah, M.D.
• Russell Sinn, M.D.
• Alexandra Smith, PA-C
• Claudet C Smith, MD
• Sonus-USA, Inc.
• James Michael Souers, DDS
• Kaelyn Nikolle Spivey
• St Paul Hermitage Home
• St. Francis Hospital

• Pediatric Nutrition Registered Dietitian in Beech Grove, IN
• Providers in Beech Grove, IN by specialty
• Pediatric Nutrition Registered Dietitian in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.