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JESSICA FITZSIMMONS-WALLACE RD, LD
NPI 1487089199
Dietitian, Registered in Duluth, MN

Active since September 12, 2013
915 E 1ST ST, DULUTH, MN 55805(218) 249-5555 Get Directions Write a Review

NPPES record last updated: September 12, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jessica Fitzsimmons-wallace Rd, Ld NPPES

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

JESSICA FITZSIMMONS-WALLACE RD, LD (NPI 1487089199) is an individual dietitian, registered in Duluth, Minnesota, licensed in Minnesota (3036) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1487089199
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameJESSICA FITZSIMMONS-WALLACECredential: RD, LD
Location Address915 E 1ST STDuluth, MN 55805-2107
Mailing Address915 E 1st StDuluth, MN 55805-2107 · (218) 249-5555
Phone(218) 249-5555
Sole ProprietorNo
Enumeration DateSeptember 12, 2013
✔ NPI 1487089199 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 MN · 3036
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.
915 E 1ST ST, Duluth, MN 55805
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Fitzsimmons-wallace Rd, Ld is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

St. Luke's Hospital Of Duluth
Same address
Nurse Anesthetist, Certified Registered
915 E 1ST ST
Duluth, MN 55805
  • Reassigned Medicare billing, Minnesota enrollment
  • 513 clinicians in this Medicare group
NPI 1003860792 (218) 249-5353

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.

SCOTT IAN HALVORSON CRNA
Nurse Anesthetist, Certified Registered
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5555
ST. LUKE'S HOSPITAL OF DULUTH
Nurse Anesthetist, Certified Registered
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5353
MARK PAUL SUOJANEN M.D.
Anesthesiology
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5352
DR. GREGORY K BERNHARDT MD
Emergency Medicine
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5616
ALAN DAVID HAGEN PT
Physical Therapist
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5555
ANTHONY RICHARD GRAND PHARMD
Pharmacist
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5555
EMILY KATHRYN EASH CRNA
Nurse Anesthetist, Certified Registered
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5352
DR. DONALD L LEAKE MD
Anesthesiology
915 E 1ST ST
DULUTH, MN 55805
St. Louis County (218) 249-5353

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 Fitzsimmons-wallace's NPI number?

The NPI number for Jessica Fitzsimmons-wallace is 1487089199. It was assigned to this individual provider in the NPPES registry on September 12, 2013.

Where is Jessica Fitzsimmons-wallace located?

Jessica Fitzsimmons-wallace practices at 915 E 1st St, Duluth, MN 55805. The listed phone number is (218) 249-5555.

What is Jessica Fitzsimmons-wallace's specialty?

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

Is Jessica Fitzsimmons-wallace enrolled in Medicare?

Yes. Jessica Fitzsimmons-wallace is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Fitzsimmons-wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Fitzsimmons-wallace reassigns Medicare benefits to St. Luke's Hospital Of Duluth (Duluth, MN). 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 Fitzsimmons-wallace'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 Fitzsimmons-wallace was last updated on September 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.