The Pantry Raider

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND5745 Issued in FL

Legal business name

THE PANTRY RAIDER

Practice address

3331 Summit Blvd Apt 16
Pensacola, FL 32503-4320

Phone

(404) 661-6781

NPI assigned

Apr 15, 2011

Last updated

Apr 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Jacobs, RDNPI 1164724936

Title

Owner

Phone

(404) 661-6781

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Jacobs, MS, RD, LD

  • Registered Dietitian
  • Pensacola, FL
  • NPI 1164724936

  Dietitian, Registered

  NPD (past) Authorized official

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1881984540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 SUMMIT BLVD APT 16",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034320",
            "telephone_number": "404-661-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 SUMMIT BLVD APT 16",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034320",
            "telephone_number": "404-661-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PANTRY RAIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-661-6781",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND5745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.