Jennifer Stack, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

122 Main St
New Paltz, NY 12561-1525

Phone

(917) 370-7888

NPI assigned

Jun 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1841783636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 374",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125250374",
            "telephone_number": "917-370-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611525",
            "telephone_number": "917-370-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "JENNIFER",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Sommers, P.T.
• Rachel Spear, LCSW
• James Theodore Spencer, MD
• Michele Lee Speranza, PH.D.
• Curtis Davis Sprague, MD
• Helen Marie Steffens, RPH
• Griffin Stockton
• Stone Mountain Counseling, LMHC, P.C.
• Jennifer Strano, LCSW-R, CASAC-T
• Orin A Strauchler, PSY.D.

• Registered Dietitian in New Paltz, NY
• Providers in New Paltz, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.