Individual provider Active NPI

Jennifer Dietz, RD, CDE, LDN, MSPH

  • Registered Dietitian
  • Danville, VA
National Provider Identifier
1790917979
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
862411 Issued in VA
Practice address
625 Piney Forest Rd Ste 306D
Danville, VA 24540-2869
Phone
(434) 548-0476
Fax
(434) 791-3330
NPI assigned
Aug 20, 2009
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 L001930 NC
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 862411 VA Primary

Addresses

Primary practice location

625 Piney Forest Rd Ste 306D
Danville, VA 24540-2869

Mailing address

625 Piney Forest Rd Ste 306D
Danville, VA 24540-2869
Phone (434) 548-0476

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000272 VA Practitioner - Registered Dietitian Or Nutrition Professional 4789716200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

625 Piney Forest Rd
Suite 306D
Danville, VA 24540-2869
Phone (434) 548-0476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L001930NCMDRegistered Dietitian
862411VAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dietz Nutritional Consulting LLC Dietitian, Registered CurrentSince Apr 25, 2010 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, 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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1790917979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD STE 306D",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402869",
            "telephone_number": "434-548-0476",
            "fax_number": "434-791-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD STE 306D",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402869",
            "telephone_number": "434-548-0476",
            "fax_number": "434-791-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "RD, CDE, LDN, MSPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L001930",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "862411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.