Individual provider Active NPI

Jillian Montgomery Wease, MS, RD, LD

  • Registered Dietitian
  • Hopkinsville, KY
National Provider Identifier
1891583043
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
265862 Issued in KY
Practice address
1724 Kenton St Ste 2B
Hopkinsville, KY 42240-1981
Phone
(270) 632-4555
Fax
(270) 632-4556
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 265862 KY Primary

Addresses

Primary practice location

1724 Kenton St Ste 2B
Hopkinsville, KY 42240-1981

Mailing address

1724 Kenton St Ste 2B
Hopkinsville, KY 42240-1981
Phone (270) 632-4555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528000497 KY Practitioner - Registered Dietitian Or Nutrition Professional 1355860958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie Stuart Medical Center Inc CurrentSince Apr 23, 2025 Accepting new patients
Jennie Stuart Medical Center Inc Current Accepting new patients
Jennie Stuart Medical Center Inc Dietitian, Registered CurrentSince Apr 23, 2025 Accepting new patients

Locations

1724 Kenton St
Ste 2B
Hopkinsville, KY 42240
Phone (270) 632-4555

10755 Eagle Way
Ste 202
Hopkinsville, KY 42240
Phone (270) 887-5640

Organizations & group practices 3

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1891583043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 KENTON ST STE 2B",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401981",
            "telephone_number": "270-632-4555",
            "fax_number": "270-632-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 KENTON ST STE 2B",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401981",
            "telephone_number": "270-632-4555",
            "fax_number": "270-632-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEASE",
        "first_name": "JILLIAN",
        "middle_name": "MONTGOMERY",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "265862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.