Active NPI
Jessica Delos Reyes Willsey, MPH, RDN, LDN
- Registered Dietitian
- Saipan, MP
National Provider Identifier
1942440920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD002840
- Practice address
- 10000 Chalan Kanoa, PMB 532
Saipan, MP 96950 - Phone
- (670) 484-4300
- NPI assigned
- Mar 3, 2009
- Last updated
- May 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD002840 | GA | Primary |
| Registered Dietitian | 133V00000X | 948371 | GA | |
| Renal Nutrition Registered Dietitian | 133VN1005X | LD002840 | GA | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 948371 | NU |
Addresses
Primary practice location
10000 Chalan Kanoa, PMB 532
Saipan, MP 96950
Mailing address
PMB 532, Box 10000
Saipan, MP 96950
Phone (670) 484-4300
Other names 1
- Jessica Estandian Delos Reyes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 948371 | GA | MD | Registered Dietitian |
| LD002840 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Islands Nutrition and Health LLC | Nutrition, Renal | Current | 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.
-
dba Linala Nutrition
- Renal Nutrition Registered Dietitian
- Saipan, MP
- NPI 1447976055
Nutrition, Renal
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1942440920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 532, BOX 10000",
"city": "SAIPAN",
"state": "MP",
"postal_code": "96950",
"telephone_number": "670-484-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 CHALAN KANOA, PMB 532",
"city": "SAIPAN",
"state": "MP",
"postal_code": "96950",
"telephone_number": "670-484-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSEY",
"first_name": "JESSICA",
"middle_name": "DELOS REYES",
"name_prefix": "Ms.",
"credential": "MPH, RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-03",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD002840",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "948371",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "GA",
"license": "LD002840",
"primary": false
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": "NU",
"license": "948371",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "DELOS REYES",
"middle_name": "ESTANDIAN",
"credential": "MPH, RDN, LDN",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Saipan, MP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.