Individual provider Active NPI

Jaci Salley, CNTP

  • Nutritionist
  • Denver, CO
National Provider Identifier
1902460298
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
1091 E Bayaud Ave Apt W1507
Denver, CO 80209-2759
Phone
(612) 207-5214
NPI assigned
Apr 23, 2019
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X CO Primary

Addresses

Primary practice location

1091 E Bayaud Ave Apt W1507
Denver, CO 80209-2759

Mailing address

1101 E Bayaud Ave Apt E1201
Denver, CO 80209-2490
Phone (612) 207-5214

Other practice location 1

4155 E Jewell Ave Ste 714
Denver, CO 80222-4515
Phone (612) 207-5214

Other practice location 2

2500 18th St
Denver, CO 80211-3908
Phone (303) 953-2899

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dabolina Corp Past Accepting new patients

Organizations & group practices 1

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1902460298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E BAYAUD AVE APT E1201",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802092490",
            "telephone_number": "612-207-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 E BAYAUD AVE APT W1507",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802092759",
            "telephone_number": "612-207-5214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155 E Jewell Ave Ste 714",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802224515",
            "country_code": "US",
            "telephone_number": "612-207-5214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 18th St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802113908",
            "country_code": "US",
            "telephone_number": "303-953-2899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALLEY",
        "first_name": "JACI",
        "credential": "CNTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.