Individual provider Active NPI

Jessica L Bettick

  • Registered Dietitian
  • Warrenton, VA
National Provider Identifier
1801252580
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
225 Oak Springs Dr
Suite 201
Warrenton, VA 20186-2187
Phone
(540) 878-5408
Fax
(540) 878-5731
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

225 Oak Springs Dr
Suite 201
Warrenton, VA 20186-2187

Mailing address

52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

Other identifiers 1

IdentifierTypeStateIssuer
994986OtherMICOMMISSION ON DIETETIC REGISTRATION- ACADEMY OF NUTRITION AND DIETETICS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302001292 VA Practitioner - Registered Dietitian Or Nutrition Professional 7416253315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Orthopaedic Associates PC 39 clinicians

Practice addresses (Care Compare)

52 W Shirley Ave
Warrenton, VA 20186-3008
Phone (540) 347-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Orthopaedic Associates PC CurrentSince Jan 22, 2016 Accepting new patients
Blue Ridge Orthopaedics Physical Therapy Past Accepting new patients

Locations

225 Oak Springs Dr
Ste 201
Warrenton, VA 20186
Phone (540) 878-5408

52 W Shirley Ave
Warrenton, VA 20186
Phone (540) 347-9220

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1801252580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W SHIRLEY AVE",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201863008",
            "telephone_number": "540-347-9220",
            "fax_number": "540-347-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 OAK SPRINGS DR",
            "address_2": "SUITE 201",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862187",
            "telephone_number": "540-878-5408",
            "fax_number": "540-878-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTICK",
        "first_name": "JESSICA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION- ACADEMY OF NUTRITION AND DIETETICS",
            "identifier": "994986",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.