Jessica Elaine Lake, MS, RDN, LD
NPI 1154910214ActiveIndividual· Dietitian, Registered· Erie, PA
Dietitian, Registered (MS, RDN, LD) in Erie, Pennsylvania, licensed in PA and OH, with an NPI issued in January 2021. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1154910214 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, RDN, LD |
| Sole proprietor | No |
| NPI issued | Jan 13, 2021 |
| Last updated in NPPES | Sep 25, 2024 |
| Certified by provider | Sep 25, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | DN007374 | PA |
| Dietitian, Registered | 133V00000X | LD.09340 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (PA) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
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