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

Q: 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.

Q: What is Jessica Lake's specialty?

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

Q: 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 22 months 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.

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: August 02, 2026.

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

On this page

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

Open in Google Maps ↗

Secondary Practice Location 1

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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

Leave this field empty

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)