Active NPI
Jessica Marie Manginelli, RD
- Registered Dietitian
- Ypsilanti, MI
National Provider Identifier
1851027809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86294229
- Practice address
- 5884 S Ivanhoe Ave
Ypsilanti, MI 48197-7112 - Phone
- (805) 509-0451
- NPI assigned
- Jul 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 86294229 | CA | Primary |
Addresses
Primary practice location
5884 S Ivanhoe Ave
Ypsilanti, MI 48197-7112
Mailing address
5884 S Ivanhoe Ave
Ypsilanti, MI 48197-7112
Phone (805) 509-0451
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
| License | State | Type | Specialty |
|---|---|---|---|
| 86294229 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659139200000",
"number": "1851027809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5884 S IVANHOE AVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481977112",
"telephone_number": "805-509-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5884 S IVANHOE AVE",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481977112",
"telephone_number": "805-509-0451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGINELLI",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-30",
"last_updated": "2022-07-30",
"certification_date": "2022-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "86294229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.