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MS. JESSICA ELAINE LAKE MS, RDN, LD
NPI 1154910214
Dietitian, Registered in Erie, PA

Active since January 13, 2021
3910 CAUGHEY RD STE 200, ERIE, PA 16506(814) 580-8808 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 25, 2024, Jan 13, 2021 (2 updates tracked since 2021).

About Ms. Jessica Elaine Lake Ms, Rdn, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JESSICA ELAINE LAKE MS, RDN, LD (NPI 1154910214) is an individual dietitian, registered in Erie, Pennsylvania, licensed in Pennsylvania (DN007374) and active in the NPI registry since January 2021. She maintains a secondary practice location in Erie and is a graduate of Other (2020).

NPPES Registry Identity

NPI1154910214
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMS. JESSICA ELAINE LAKECredential: MS, RDN, LD
Location Address3910 CAUGHEY RD STE 200Erie, PA 16506-4098
Mailing Address3910 Caughey Rd Ste 200Erie, PA 16506-4098 · (814) 580-8808
Phone(814) 580-8808
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 13, 2021
Last NPPES UpdateSeptember 25, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2024
✔ NPI 1154910214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in PA · DN007374✔ Licensed in OH · LD.09340
Definition
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.
3910 CAUGHEY RD STE 200, Erie, PA 16506
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Secondary Practice Location 1

Location 19345 Lake Pleasant RdErie, PA 16509-5755 · Phone (814) 580-8808

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jessica Elaine Lake Ms, Rdn, Ld is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921447756
PECOS Enrollment IDI20240412003163

Medicare Billing Reassignment

Medicare enrollment records show Jessica Lake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jessy Brinling Nutrition LLC
Same address
Dietitian, Registered
3910 CAUGHEY RD STE 200
Erie, PA 16506
  • Reassigned Medicare billing, Pennsylvania enrollment
NPI 1669234381 (814) 580-8808

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATELYNNE HANKINS LPC
Counselor (Mental Health)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 480-9890
NOTE TO SELF THERAPY AND WELLNESS LLC
Social Worker (Clinical)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 259-1041
SEXUAL WELLNESS PA, LLC
Counselor (Professional)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 580-8677
RENEE M. KIRBY LSW CADC
Social Worker
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 480-9323
ERIE HORIZON HEALING SERVICES
Counselor (Professional)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 413-0827
NICOLE KNIGHT MA, LPC
Counselor (Professional)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 732-0309
LIANA CHRISTIANSEN LCSW
Social Worker (Clinical)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 464-5895
WELL OF RENEWAL WITH RENEE, LLC
Social Worker (Clinical)
3910 CAUGHEY RD STE 200
ERIE, PA 16506
Erie County (814) 460-9753

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Lake's NPI number?

The NPI number for Jessica Lake is 1154910214. It was assigned to this individual provider in the NPPES registry on January 13, 2021.

Where is Jessica Lake located?

Jessica Lake practices at 3910 Caughey Rd Ste 200, Erie, PA 16506. The listed phone number is (814) 580-8808.

What is Jessica Lake's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Jessica Lake enrolled in Medicare?

Yes. Jessica Lake is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Lake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Lake reassigns Medicare benefits to Jessy Brinling Nutrition LLC (Erie, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jessica Lake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jessica Lake was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.