| Roberta O'connor Jupp, RD | |
|
147 Vera Rd Ste E, Lexington, SC 29072-3756 | |
| (803) 399-0212 | |
| (803) 728-3224 |
| Full Name | Roberta O'connor Jupp |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 35 Years |
| Location | 147 Vera Rd Ste E, Lexington, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659405512 | NPI | - | NPPES |
| DPE012 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 726464 (South Carolina) | Secondary |
| 133V00000X | Dietitian, Registered | 131 (South Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Path Of Life Nutrition | 4082960703 | 3 |
| Provider Name | Path Of Life Nutrition |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1245610534 PECOS PAC ID: 4082960703 Enrollment ID: O20180710002242 |
| Provider Name | Lexington Health Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1710634753 PECOS PAC ID: 2567872070 Enrollment ID: O20201208000922 |
| Mailing Address | Practice Location Address |
|---|---|
| Roberta O'connor Jupp, RD 723 Elliptic Green Ln, Lexington, SC 29073-7057 Ph: (803) 622-9104 | Roberta O'connor Jupp, RD 147 Vera Rd Ste E, Lexington, SC 29072-3756 Ph: (803) 399-0212 |
Jose Rodriguez, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4721 Sunset Blvd, Suite D, Lexington, SC 29072 Phone: 803-996-0312 Fax: 803-957-2496 | |
Betty Washington, MA, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1070 S Lake Dr Ste B, Lexington, SC 29073 Phone: 803-785-6622 Fax: 803-785-6555 | |
Claire Stevens Tidwell, MS, RDN, LD, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 349 Spruce Glen Rd, Lexington, SC 29072 Phone: 828-712-3885 | |
Maria Colchin, RD LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 147 Vera Rd Ste A, Lexington, SC 29072 Phone: 803-575-0468 Fax: 803-728-3224 | |
Susan Sullivan Nutrition Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 257 Avensong Dr, Lexington, SC 29072 Phone: 803-603-1700 | |
Mrs. Katherine Lisa Bernard, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 137 E Butler St, Lexington, SC 29072 Phone: 516-380-9935 | |
Farrah Wigand, RDN, LD, CSOWM Dietitian Medicare: Not Enrolled in Medicare Practice Location: 140 Royal Creek Dr, Lexington, SC 29072 Phone: 803-814-4218 |