Individual provider Active NPI

Jennifer Nenni, RDN

  • Registered Dietitian
  • Geneva, IL
National Provider Identifier
1881029122
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.001599 Issued in IL
Practice address
308 Randall Rd Ste B
Geneva, IL 60134-4201
Phone
(630) 315-1700
Fax
(630) 938-8330
NPI assigned
Sep 5, 2013
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 164.001599 IL Primary

Addresses

Primary practice location

308 Randall Rd Ste B
Geneva, IL 60134-4201

Mailing address

308 Randall Rd Ste B
Geneva, IL 60134-4201
Phone (630) 315-1700

Other practice location 1

39W905 Louisa May Alcott Ln
Saint Charles, IL 60175-7760
Phone (630) 587-5601

Other names 1

  • Miss Jennifer Boardman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118000800 IL Practitioner - Registered Dietitian Or Nutrition Professional 3678007317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

308 Randall Rd
Suite B
Geneva, IL 60134-4201
Phone (630) 262-6077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164.001599ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 15, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 15, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

626 Bethany Rd
DeKalb, IL 60115
Phone (815) 748-8993

308 Randall Rd
Ste B
Geneva, IL 60134
Phone (630) 262-0279

875 Roosevelt Rd
Glen Ellyn, IL 60137
Phone (630) 469-7858

1310 N Main St
Ste 207
Sandwich, IL 60548
Phone (815) 786-3684

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1881029122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 RANDALL RD STE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344201",
            "telephone_number": "630-315-1700",
            "fax_number": "630-938-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 RANDALL RD STE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344201",
            "telephone_number": "630-315-1700",
            "fax_number": "630-938-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39W905 Louisa May Alcott Ln",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "IL",
            "postal_code": "601757760",
            "country_code": "US",
            "telephone_number": "630-587-5601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NENNI",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.001599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOARDMAN",
            "prefix": "MISS",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Geneva, IL

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.
  • 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.