Individual provider Active NPI

Jace Rhoden, RD, LD

  • Sports Dietetics Nutrition Registered Dietitian
  • Dallas, TX
National Provider Identifier
1780376871
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
License
DT84650 Issued in TX
Practice address
6541 Shady Brook LN Apt 8207
Dallas, TX 75206-9128
Phone
(325) 370-1830
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X DT84650 TX Primary

Addresses

Primary practice location

6541 Shady Brook LN Apt 8207
Dallas, TX 75206-9128

Mailing address

6541 Shady Brook LN Apt 8207
Dallas, TX 75206-9128

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

LicenseStateTypeSpecialty
DT84650TXMDSports Dietetics Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fit for Him, LLC Nutrition, Sports Dietetics CurrentSince May 28, 2023 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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1780376871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6541 SHADY BROOK LN APT 8207",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752069128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6541 SHADY BROOK LN APT 8207",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752069128",
            "telephone_number": "325-370-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODEN",
        "first_name": "JACE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "TX",
            "license": "DT84650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.