Jeremy Benhur Ocampos Maanum, RD, LRD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1220 Issued in ND

Practice address

2400 32ND Ave S
Fargo, ND 58103-5800

Phone

(701) 234-8656

NPI assigned

Sep 2, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924
  NPD
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1790405207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035800",
            "telephone_number": "701-234-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAANUM",
        "first_name": "JEREMY",
        "middle_name": "BENHUR OCAMPOS",
        "credential": "RD, LRD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maa Enterprise LLC
• Brody Maack, PHARM.D.
• Sarah Maack, RN, CDE
• Adriane Maag Carney, L.AC.
• Nafisa Yunis Maalim
• Brooke Maatz, NP
• Heavenly Lace Mabe
• Jamie Mabe
• Rena M Macarthur, B.S.
• Kylie Christine Macdonald

• Registered Dietitian in Fargo, ND
• Providers in Fargo, ND by specialty
• Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.