Individual provider Active NPI

Jenna Rose Talleda, R.D., L.D./N, CIEC

  • Nutritionist
  • Naples, FL
National Provider Identifier
1780813733
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
ND5196 Issued in FL
Practice address
1448 Churchill Cir # S204
Naples, FL 34116-3613
Phone
(239) 338-7420
NPI assigned
Jul 13, 2009
Last updated
Oct 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND5196 FL
Nutritionist 133N00000X ND5196 FL Primary

Addresses

Primary practice location

1448 Churchill Cir # S204
Naples, FL 34116-3613

Mailing address

1448 Churchill Cir # S204
Naples, FL 34116-3613
Phone (239) 338-7420

Other practice location 1

8961 Daniels Center Dr Ste 401
Fort Myers, FL 33912-0314
Phone (239) 433-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260314000336 FL Practitioner - Registered Dietitian Or Nutrition Professional 9032692322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19 W 24TH St
FL 4
New York, NY 10010-3239

19 W 24TH St FL
Suite 4
New York, NY 10010-3239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND5196FLMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
BSH Health PA Dietitian, Registered CurrentSince Mar 1, 2026 Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Locations

2820 NE 214th St
Ste 801
Miami, FL 33180
Phone (305) 204-9877

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1780813733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 CHURCHILL CIR # S204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341163613",
            "telephone_number": "239-338-7420",
            "fax_number": "239-433-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 CHURCHILL CIR # S204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341163613",
            "telephone_number": "239-338-7420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8961 Daniels Center Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339120314",
            "country_code": "US",
            "telephone_number": "239-433-6700",
            "fax_number": "239-433-6703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLEDA",
        "first_name": "JENNA",
        "middle_name": "ROSE",
        "credential": "R.D., L.D./N, CIEC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND5196",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND5196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.