JEREMY DOUGLAS RDN
NPI 1366122293
Dietitian, Registered in Atlanta, GA

Q: What is Jeremy Douglas's NPI number?

The NPI number for Jeremy Douglas is 1366122293. It was assigned to this individual provider in the NPPES registry on July 25, 2023.

Q: What is Jeremy Douglas's specialty?

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

Q: Is Jeremy Douglas enrolled in Medicare?

No. Jeremy Douglas has opted out of Medicare through September 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Douglas was last updated on January 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 July 25, 2023Opted out of Medicare · through Sep 18, 2027

1380 W MARIETTA ST NW, ATLANTA, GA 30318(614) 738-1343 Get Directions Write a Review

NPPES record last updated: January 11, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Jan 11, 2026, Aug 14, 2023, Jul 25, 2023 (3 updates tracked since 2023).

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About Jeremy Douglas Rdn NPPES

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

JEREMY DOUGLAS RDN (NPI 1366122293) is an individual dietitian, registered in Atlanta, Georgia, licensed in Georgia (LD006597) and active in the NPI registry since July 2023. He has opted out of Medicare through September 18, 2027.

NPPES Registry Identity

NPI1366122293

Entity TypeIndividualMale

Primary Taxonomy133V00000X

Provider Legal NameJEREMY DOUGLASCredential: RDN

Location Address1380 W MARIETTA ST NWAtlanta, GA 30318-4974

Mailing Address4104 Peachford CirDunwoody, GA 30338-6488

Phone(614) 738-1343

Sole ProprietorYes

Enumeration DateJuly 25, 2023

Last NPPES UpdateJanuary 11, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2026

✔ NPI 1366122293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in GA · LD006597

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.

1380 W MARIETTA ST NW, Atlanta, GA 30318

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jeremy Douglas Rdn has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 18, 2025 through September 18, 2027.

Opt-Out Effective DateSeptember 18, 2025

Opt-Out In Effect ThroughSeptember 18, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

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

KRISTEN AVERA RD, LD, CDCES

Dietitian, Registered

1380 W MARIETTA ST NW
ATLANTA, GA 30318

Fulton County (404) 981-6533

SIERRA WOODRUFF MS, RDN, LD

Dietitian, Registered

1380 W MARIETTA ST NW
ATLANTA, GA 30318

Fulton County (404) 419-3330

ALIZA LUKOWSKI

Dietitian, Registered

1380 W MARIETTA ST NW
ATLANTA, GA 30318

Fulton County (404) 419-3325

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 Jeremy Douglas's NPI number?

The NPI number for Jeremy Douglas is 1366122293. It was assigned to this individual provider in the NPPES registry on July 25, 2023.

Where is Jeremy Douglas located?

Jeremy Douglas practices at 1380 W Marietta St NW, Atlanta, GA 30318. The listed phone number is (614) 738-1343.

What is Jeremy Douglas's specialty?

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

Is Jeremy Douglas enrolled in Medicare?

No. Jeremy Douglas has opted out of Medicare through September 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jeremy Douglas was last updated on January 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.