Individual provider Active NPI

Jaylin Staunton

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1821812579
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86043559 Issued in PA
Practice address
2317 E Hagert St
Philadelphia, PA 19125-2107
Phone
(484) 269-9109
NPI assigned
Nov 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 86043559 PA Primary

Addresses

Primary practice location

2317 E Hagert St
Philadelphia, PA 19125-2107

Mailing address

2317 E Hagert St
Philadelphia, PA 19125-2107

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

State licenses

LicenseStateTypeSpecialty
86043559PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Marjorie Nolan Cohn LLC 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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1821812579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 E HAGERT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 E HAGERT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252107",
            "telephone_number": "484-269-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUNTON",
        "first_name": "JAYLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "86043559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

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

Verify at the official NPI Registry.