Active NPI
Madison Jacobs, MS, RD, LD
- Registered Dietitian
- Overland Park, KS
National Provider Identifier
1801613823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT88672
- Practice address
- 6743 W 135TH St
Overland Park, KS 66223-8060 - Phone
- (515) 577-1868
- NPI assigned
- Sep 21, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT88672 | TX | Primary |
Addresses
Primary practice location
6743 W 135TH St
Overland Park, KS 66223-8060
Mailing address
6743 W 135TH St Apt 409
Overland Park, KS 66223-8035
Phone (515) 577-1868
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT88672 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | 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": "1726876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732406400000",
"number": "1801613823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6743 W 135TH ST APT 409",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662238035",
"telephone_number": "515-577-1868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6743 W 135TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662238060",
"telephone_number": "515-577-1868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "MADISON",
"credential": "MS, RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-21",
"last_updated": "2024-11-24",
"certification_date": "2024-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT88672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.