JENNIFER MIMKHA (NPI# 1558838672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558838672 |
| Entity Type | Individual |
| Full Name | JENNIFER MIMKHA |
| Other Name | JENNIFER STAFFORD |
| Credential | MPH RD LDN CLC CLT |
| Practice Address |
11850 Dr Martin Luther King St N Apt 12304 Saint Petersburg FL 33716-1631 |
| Practice Telephone | 4846202785 |
| Mailing Telephone | 4846202785 |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2018-10-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | ND6949 | FL | Dietary & Nutritional Service Providers |
| Street Address |
11850 DR MARTIN LUTHER KING ST N APT 12304 |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33716-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699205815 | Orthopaedic Medical Group of Tampa Bay Pa | Clinic/Center | 10033 Mlk Jr St N Fl 3, St Petersburg, FL 33716 | 2017-06-20 |
| 1316471113 | Sara Alexandra Maltese | Dentist | 871 Ibis Walk Pl N Unit 7201, St Petersburg, FL 33716 | 2017-04-18 |
| 1508229972 | Florida Cardiac Therapeutics, Inc | Internal Medicine | 10033 Doctor M.l.k. Jr St N, Suite 302, St Petersburg, FL 33716 | 2016-04-01 |
| 1720440902 | Valorie Baker | Day Training, Developmentally Disabled Services | 115 112th Ave Ne Apt 627, St Petersburg, FL 33716 | 2016-03-25 |
| 1346611142 | Theresa Bowen | Occupational Therapist | 810 S. Village Drive N, #103, St. Petersburg, FL 33716 | 2015-10-19 |
| 1356775423 | Paula J Smith | Massage Therapist | 400 Carillon Pkwy #130, Mountain Tree Massage, LLC, St. Petersburg, FL 33716 | 2013-08-26 |
| 1699118596 | Kellie L Kintz | Social Worker | 540 Carillon Parkway, Apartment 3026, The Promenade At Carillon, St. Petersburg, FL 33716 | 2013-04-10 |
| 1427398288 | St. Petersburg General Hospital | General Acute Care Hospital | 11850 Doctor Martin Luther King Jr. St. North, Apt 22-312, St Petersburg, FL 33716 | 2013-02-15 |
| 1952657314 | Trudy Anna Glover | Occupational Therapy Assistant | 11850 9th Street North, Apt 20208, St Petersburg, FL 33716 | 2012-08-02 |
| 1275834129 | Prison Rehabilitative Industries & Diversified Enterprises | Dental Laboratory | 12425 28th St. N., Suite 300, St. Petersburg, FL 33716 | 2010-11-09 |
| Find all providers in zip 33716 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617446 | Madisyn Becker | Dietitian, Registered | 871 Ibis Walk Pl N Unit 7203, Saint Petersburg, FL 33716-3843 | 2020-10-19 |
| 1487264339 | Nicole Fresta | Dietitian, Registered | 1590 79th Ave N, Saint Petersburg, FL 33702-4039 | 2020-08-05 |
| 1851914360 | Anthony Thomas Robinson | Dietitian, Registered | 2025 Lakewood Club Dr S Apt A, Saint Petersburg, FL 33712-4951 | 2020-05-19 |
| 1194381954 | Jessica Mccann | Dietitian, Registered | 1727 New Hampshire Ave Ne, Saint Petersburg, FL 33703-3347 | 2019-05-16 |
| 1023573755 | Elizabeth Wilson | Dietitian, Registered | 8424 4th St N, Saint Petersburg, FL 33702-3659 | 2019-02-06 |
| 1376055368 | Laura Richardson | Dietitian, Registered | 1858 Michigan Ave Ne, Saint Petersburg, FL 33703-3332 | 2017-10-30 |
| 1770936304 | Vanessa Carr | Dietitian, Registered | 720 9th St S, Saint Petersburg, FL 33701-4718 | 2016-07-19 |
| 1982036695 | Darbie Leigh Wilder | Dietitian, Registered | 184 Valencia Cir, Saint Petersburg, FL 33716-1298 | 2013-08-05 |
| 1124305487 | Sasha Ocampo | Dietitian, Registered | 317 34th Ave N Apt 407, Saint Petersburg, FL 33704-1342 | 2011-11-14 |
| 1710014279 | Gayle Maude Mousseau | Dietitian, Registered | 1139 Bay St Ne, Saint Petersburg, FL 33701-1828 | 2007-02-28 |
| Find all providers in SAINT PETERSBURG | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33716 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.