P Praxis·MD
● Active Type 1 · Individual

Jacqlyn Raivo, RDN

Dietitian, Registered·Meridian, ID· NPI 1740746403 · Enumerated 2019 · 7 years on NPI
Raivo is 1 of 50 dietitian, registered providers in Meridian and 1 of 505 in Idaho.
NPI age
7 years
Enumerated 2019-02-18
Primary specialty
Dietitian, Registered
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-02-18
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 505 active dietitian, registered providers in Idaho.

NPI age
7 years
≈ at median (7 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties

NPI lifetime · 2019 → 2026

2019-02Enumerated in NPPES
2019 2026

Where they practice

Practice location
1859 S Topaz Way Ste 100
Meridian, ID 836424401
📞 2082092432fax 8478595885
Mailing address
175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 600611454
📞 8477378768fax 8478595885

Specialties

  • Dietitian, Registered Primary
    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...
    ID license #D1101 taxonomy 133V00000X

Practice context

Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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