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Active NPI 1235776816 Individual Practitioner Female Practitioner

Jaci Elizabeth Lake , RD

Dietitian, Registered • Centralia, IL

Professional Overview & Biography Verified Profile Summary

Jaci Lake, RD is a registered healthcare professional specializing in Dietitian, Registered in Centralia, IL. Practice services are available at 432 N PLEASANT AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

432 N Pleasant Ave

Centralia, IL 628013006

Telephone 6184368114

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Centralia, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Centralia, IL (2895 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License IL 164.006872

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Secondary Practice Locations

5 Good Samaritan Way

Mount Vernon, IL 628642402

Phone: 6184368114

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Stacy Menees , FNP

Nurse Practitioner - Family

NPI 1386815959

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 03, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location December 03, 2019

Registered at 432 N PLEASANT AVE, CENTRALIA, IL 628013006 (Tel: 6184368114)

📍
Updated Business Mailing Address December 03, 2019

Registered at 7843 COOLIDGE RD, OAKDALE, IL 622681415 (Tel: 6189783551)

👤
Provider Name / Credentials Updated December 03, 2019

Recorded as JACI LAKE, RD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 03, 2019

Dietitian, Registered (License #164.006872 in IL)

🟢
Initial NPI Registration & Enumeration December 03, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1235776816
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 03, 2019
Last Update: December 03, 2019
Sole Proprietor: No

Mailing Address

7843 Coolidge Rd

Oakdale, IL 622681415

Phone: 6189783551

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.