Active NPI
Jennely Cardona
- Registered Dietitian
- Conroe, TX
National Provider Identifier
1922877992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 88329
- Practice address
- 15710 Koi Gardens LN
Conroe, TX 77302-1421 - Phone
- (787) 469-8857
- NPI assigned
- Jan 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1820 | PR | |
| Registered Dietitian | 133V00000X | 88329 | TX | Primary |
Addresses
Primary practice location
15710 Koi Gardens LN
Conroe, TX 77302-1421
Mailing address
15710 Koi Gardens LN
Conroe, TX 77302-1421
Phone (787) 469-8857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260530000594 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 2668942624 | Practice locations: Guaynabo, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2 -6 Calle Munoz Ferrer St
Guaynabo, PR 00926-5706
Phone (787) 402-7304
Calle Lirio
G9 Caribe Gardens
Caguas, PR 00725-5527
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88329 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704067200000",
"number": "1922877992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15710 KOI GARDENS LN",
"city": "CONROE",
"state": "TX",
"postal_code": "773021421",
"telephone_number": "787-469-8857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15710 KOI GARDENS LN",
"city": "CONROE",
"state": "TX",
"postal_code": "773021421",
"telephone_number": "787-469-8857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDONA",
"first_name": "JENNELY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-01",
"last_updated": "2024-01-01",
"certification_date": "2023-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1820",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "88329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.