Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306878079 Individual Practitioner Female Practitioner

Jerilyn Ann Jackson , RD

Dietitian, Registered • Pawtucket, RI

Professional Overview & Biography Verified Profile Summary

Jerilyn Jackson, RD is a registered healthcare professional specializing in Dietitian, Registered in Pawtucket, RI. Practice services are available at 111 BREWSTER ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

111 Brewster St

Pawtucket, RI 028604400

Telephone 4017292360
Fax 4017292179
Associated Practice Facility / Clinic
🏢 Memorial Hospital Facility NPI 1063441640

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Pawtucket, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.0 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
13 Specialists

Practicing in Pawtucket, RI (372 Statewide)

Telehealth Adoption Rate
7.7% 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

CMS Verified: 2026-07-31
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License RI LDN00388

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Health Care
2038776 (RI)
Commercial Insurance / Payer ID Blue Cross
20695-0 (RI)
Commercial Insurance / Payer ID Blue Chip
CP00404528 (RI)

Secondary Practice Locations

1170 Pontiac Ave

Cranston, RI 029207944

Phone: 4018959937

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Mahmoud Mowafy , MD

Internal Medicine

NPI 1003369042

Doctor of Medicine (M.D.)

Dr. Ashley Mastrangelo , DPM

Podiatrist - Foot & Ankle Surgery

NPI 1013323419

Doctor of Podiatric Medicine

Dr. John Riedel , MD

Emergency Medicine

NPI 1033194105

Doctor of Medicine (M.D.)

Dr. Jaleh Fallah , MD

Internal Medicine - Hematology & Oncology

NPI 1063826188

Doctor of Medicine (M.D.)

Colleen Foley-Lunt

Speech-Language Pathologist

NPI 1073657441
NPI 1083354757

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

7 Historical Events
📍
Updated Business Mailing Address July 31, 2026

Registered at 420 SCRABBLETOWN RD STE A, NORTH KINGSTOWN, RI 028523638 (Tel: 4013434343)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 111 BREWSTER ST, PAWTUCKET, RI 028604400 (Tel: 4017292360)

📍
Updated Business Mailing Address July 08, 2007

Registered at 111 BREWSTER ST, PAWTUCKET, RI 028604400 (Tel: 4017292360)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JERILYN JACKSON, R.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dietitian, Registered (License #LDN00388 in RI)

🟢
Initial NPI Registration & Enumeration July 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306878079
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2006
Last Update: July 31, 2026
Sole Proprietor: No

Mailing Address

420 Scrabbletown Rd Ste A

North Kingstown, RI 028523638

Phone: 4013434343

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.