Jennifer Stack Dietitian PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

JENNIFER STACK DIETITIAN PLLC

Practice address

122 Main St
New Paltz, NY 12561

Phone

(917) 370-7888

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer Stack, RD

Title

Owner/Rd

Phone

(917) 370-7888

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa M Thompson, LCSWR

  • Clinical Social Worker
  • Highland, NY
  • NPI 1538272349
  NPD (past)

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1972098655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 374",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125250374",
            "telephone_number": "917-370-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "12561",
            "telephone_number": "917-370-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Milton Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "NY",
            "postal_code": "125281415",
            "country_code": "US",
            "telephone_number": "917-370-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JENNIFER STACK DIETITIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/RD",
        "authorized_official_telephone_number": "917-370-7888",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1841783636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon H James, RPH
• Richard M Janof, DC
• Jansen Road Nursing and Rehabilitation Center LLC
• Denise Katherine Jelley, LCSW R
• Jemma Schwartz LCSW PLLC
• Florence L Jerdan, RN, PHD
• Judy Joffee, CNM
• Johanna Scaglione, PH.D.,LCSW
• Ellen Meredith Johnson, LMHC
• Michelle M Johnson, MS, ATC

• Registered Dietitian in New Paltz, NY
• Providers in New Paltz, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.