Individual provider Active NPI

Emily Rose Conyers, MS, RDN, CSR, LD/N

  • Registered Dietitian
  • Jacksonville, FL
National Provider Identifier
1811474695
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND7660 Issued in FL
Practice address
12866 Daybreak CT E
Jacksonville, FL 32246-7095
Phone
(904) 497-0401
Fax
(833) 773-1288
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1501X ND7660 FL
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X LD006417IU GA
Nutrition Education Nutritionist 133NN1002X ND7660 FL
Nutritionist 133N00000X ND7660 FL
Registered Dietitian 133V00000X LD006417IU GA
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X ND7660 FL Primary
Obesity and Weight Management Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1201X ND7660 FL
Renal Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1005X LD006417IU GA
Renal Nutrition Registered Dietitian 133VN1005X ND7660 FL
Gerontological Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1101X ND7660 FL
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X LD006417IU GA

Addresses

Primary practice location

12866 Daybreak CT E
Jacksonville, FL 32246-7095

Mailing address

12866 Daybreak CT E
Jacksonville, FL 32246-7095
Phone (904) 497-0401

Other names 1

  • Ms. Emily Rose Greco Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211002636 FL Practitioner - Registered Dietitian Or Nutrition Professional 0840626842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12866 Daybreak CT E
Jacksonville, FL 32246-7095
Phone (904) 497-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ND7660FLMDRegistered Dietitian
LD006417IUGAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Rose Nutrition, LLC Nutritionist CurrentSince Jul 7, 2020 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

4320 Deerwood Lake Pkwy
Ste 101140
Jacksonville, FL 32216
Phone (904) 497-0401

589 Palisade Dr
Brunswick, GA 31523

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1811474695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12866 DAYBREAK CT E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467095",
            "telephone_number": "904-497-0401",
            "fax_number": "833-773-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12866 DAYBREAK CT E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467095",
            "telephone_number": "904-497-0401",
            "fax_number": "833-773-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONYERS",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, CSR, LD/N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "GA",
            "license": "LD006417IU",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD006417IU",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND7660",
            "primary": true
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "GA",
            "license": "LD006417IU",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133VN1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "FL",
            "license": "ND7660",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "GA",
            "license": "LD006417IU",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GRECO",
            "middle_name": "ROSE",
            "prefix": "MS.",
            "credential": "MS, RDN, LD/N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; 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.