Active NPI
Jena Rae Seely
- Registered Dietitian
- Mesa, AZ
National Provider Identifier
1972465656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LRD3514RD
- Practice address
- 1418 S Almar
Mesa, AZ 85204-6463 - Phone
- (928) 202-7709
- NPI assigned
- Dec 1, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LRD3514RD | SC | Primary |
Addresses
Primary practice location
1418 S Almar
Mesa, AZ 85204-6463
Mailing address
843 Wood Village Dr
Edgemoor, SC 29712-7744
Phone (704) 839-1989
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 |
|---|---|---|---|
| LRD3514RD | SC | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764547200000",
"number": "1972465656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "843 WOOD VILLAGE DR",
"city": "EDGEMOOR",
"state": "SC",
"postal_code": "297127744",
"telephone_number": "704-839-1989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 S ALMAR",
"city": "MESA",
"state": "AZ",
"postal_code": "852046463",
"telephone_number": "928-202-7709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEELY",
"first_name": "JENA",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-01",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "LRD3514RD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.