JENNIFER KELLER BOURBONNAIS (NPI# 1710005608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710005608 |
| Entity Type | Individual |
| Full Name | JENNIFER KELLER BOURBONNAIS |
| Other Name | JENNIFER KELLER |
| Credential | MED RD |
| Practice Address |
45660 Schoenherr Rd Shelby Township MI 48315-6033 |
| Mailing Address |
43750 Garfield Rd Suite 104 Clinton Township MI 48038-1135 |
| Practice Telephone | 5862266843 |
| Practice Fax Number | 5865663068 |
| Mailing Telephone | 5862266865 |
| Mailing Fax Number | 5862266880 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 864114 | MI | Dietary & Nutritional Service Providers |
| Street Address |
45660 SCHOENHERR RD |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip Code | 48315-6033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306320627 | Nathan Lloyd White | Social Worker | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2018-09-21 |
| 1649604968 | Patricia Marie Delougherty | Social Worker | 45660 Schoenherr Rd, Shelby Township, MI 48315 | 2013-08-22 |
| 1548514904 | Nicholas Weiss | Social Worker | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2012-11-06 |
| 1902156888 | Jill Hanna Wasserman | Counselor | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2012-09-18 |
| 1649528167 | Robert Lewis Thoms | Counselor | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2012-08-15 |
| 1023386398 | Eastwood Community Clinics | Psychologist | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2011-12-01 |
| 1952688814 | Ascension Eastwood Behavioral Health | Counselor | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2011-11-07 |
| 1740427897 | Lynda Kinsell Velanovich | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2009-01-12 |
| 1356525562 | Medical Resource Group | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2007-12-24 |
| 1548442742 | Maria Catherine Lijoi | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2007-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885500 | Steven William Scavone | Counselor | 45660 Schonherr Rd., Shelby Township, MI 48315 | 2020-09-08 |
| 1861039844 | Lauren Nicole Himmel | Physician Assistant | 13051 Michael Dr., Shelby Twp., MI 48315 | 2019-12-09 |
| 1881173763 | Shelby Family Cosmetic & Restorative Dentistry | Dentist | 51221 Schoenherr Road., Suite 102, Shelby Township, MI 48315 | 2018-08-10 |
| 1023594223 | Apex Chiropractic, P.C. | Chiropractor | 51543 Schoenherr Road, Shelby Township, MI 48315 | 2018-07-11 |
| 1053809145 | Bam Management | Clinic/Center | 13433 Hall Road, Utica, MI 48315 | 2018-04-25 |
| 1659723203 | Patricia Gates | Registered Nurse | 23066 Balcombe, Utica, MI 48315 | 2016-07-07 |
| 1124481213 | Jai Shree Umiya Inc | Durable Medical Equipment & Medical Supplies | 13350 24 Mile Rd Ste 300, Shelby Township, MI 48315 | 2016-04-05 |
| 1679931828 | Team Rehabilitation S3, LLC | Physical Therapist | 13350 24 Mile Road, Suite 500, Shelby Township, MI 48315 | 2016-02-03 |
| 1164816484 | Sylvia White | Case Manager/Care Coordinator | 47100 Schoenherr Rd. Suite D, Shelby Township, MI 48315 | 2015-03-25 |
| 1770921389 | Amy Christine Vitale | Speech-Language Pathologist | 14145 Simone Dr., Developing Connections Inc, Shelby Twp, MI 48315 | 2013-06-06 |
| Find all providers in zip 48315 | ||||
| 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 |
|---|---|---|---|---|
| 1154936615 | Alyssa C Washeleski | Dietitian, Registered | 14562 Patterson Dr, Shelby Township, MI 48315-4929 | 2020-09-11 |
| 1588178743 | Tracy Lee Polega | Dietitian, Registered | 53405 Wolf Dr, Shelby Township, MI 48316-2647 | 2017-11-27 |
| 1639594799 | Stephanie Bazydlo | Dietitian, Registered | 50505 Schoenherr Rd, Suite 240, Shelby Township, MI 48315-3140 | 2014-02-26 |
| 1649411273 | Lisa Doyle-mcfarland | Dietitian, Registered | 14203 Rick Dr, Shelby Township, MI 48315-2935 | 2009-03-11 |
| 1740427897 | Lynda Kinsell Velanovich | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2009-01-12 |
| 1356525562 | Medical Resource Group | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2007-12-24 |
| 1548442742 | Maria Catherine Lijoi | Dietitian, Registered | 45660 Schoenherr Rd, Shelby Township, MI 48315-6033 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850011 | Timothy Matthews | Dietitian, Registered | 5057 Jeddo Rd, Grant Township, MI 48032-1402 | 2020-10-31 |
| 1548860075 | Mona Alaudhi | Dietitian, Registered | 3280 Washtenaw Ave Ste B, Ann Arbor, MI 48104-4283 | 2020-10-26 |
| 1497354823 | Carrie Elizabeth Couretas | Dietitian, Registered | 469 W Baker Ave, Clawson, MI 48017-1535 | 2020-10-17 |
| 1881292506 | Meghan Kathleen Pendleton | Dietitian, Registered | 26025 Pillsbury St, Farmington Hills, MI 48334-4345 | 2020-10-14 |
| 1861090771 | Stephanie Spence | Dietitian, Registered | 5629 Summer Ridge Ct Apt F, Kalamazoo, MI 49009-1058 | 2020-10-13 |
| 1902404908 | Christine L Lauer | Dietitian, Registered | 24 Coral Dr Ne, Rockford, MI 49341-8514 | 2020-10-12 |
| 1598372831 | Ann Christine Whetstone | Dietitian, Registered | 1731 Barrington Pl, Ann Arbor, MI 48103-5606 | 2020-09-30 |
| 1942817580 | Nourished Living LLC | Dietitian, Registered | 22811 Greater Mack Ave Ste 210, Saint Clair Shores, MI 48080-2054 | 2020-09-28 |
| 1396352225 | Elizabeth Ferrall Consulting LLC | Dietitian, Registered | 10200 17 Mile Rd, Marshall, MI 49068-9797 | 2020-09-24 |
| 1720694086 | Kelly Wilson | Dietitian, Registered | 6865 Hitchingham Rd, Ypsilanti, MI 48197-8998 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
| City | SHELBY TOWNSHIP |
| Zip Code | 48315 |
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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.