Individual provider Active NPI

Jacquelyn Ann Morrissey, RD

  • Oncology Nutrition Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1932030020
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X
License
DN005757 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111-2497
Phone
(215) 990-4310
Fax
(215) 214-3713
NPI assigned
May 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Nutrition Registered Dietitian 133VN1301X DN005757 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111-2497

Mailing address

310 Quigley Ave
Willow Grove, PA 19090-3512
Phone (215) 990-4310

Other names 1

  • Ms. Jacquelyn Ann Costa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3500 N Broad St
RM 1a
Philadelphia, PA 19140-4106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN005757PAMDOncology Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1932030020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 QUIGLEY AVE",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190903512",
            "telephone_number": "215-990-4310",
            "fax_number": "215-214-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112497",
            "telephone_number": "215-990-4310",
            "fax_number": "215-214-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISSEY",
        "first_name": "JACQUELYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "PA",
            "license": "DN005757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "COSTA",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.