MR. JONATHAN WYMORE (NPI# 1912449919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912449919 |
| Entity Type | Individual |
| Full Name | MR. JONATHAN WYMORE |
| Other Name | JONATHAN DOUGLAS WYMORE |
| Credential | RD, LD |
| Practice Address |
620 Elm St Sw # 2 Albany OR 97321-1986 |
| Practice Telephone | 5418124839 |
| Mailing Telephone | 5418124839 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | LDD10175002 | OR | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| COMMISION ON DIETETIC REGISTRATION | 86065504 | 01 | |
| OR | OREGON DIETETIC LICENSURE | LDD10175002 | 01 |
| Street Address |
620 ELM ST SW # 2 |
| City | ALBANY |
| State | OR |
| Zip Code | 97321-1986 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114469103 | Samaritan Health Services | General Acute Care Hospital | 620 Elm St Sw # 2, Albany, OR 97321-1986 | 2016-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730659228 | Waverly Assisted Living, LLC | In Home Supportive Care | 2853 Salem Ave Se Ste A, Albany, OR 97321 | 2018-11-28 |
| 1558838706 | Greater Albany Public Schools 8j | Local Education Agency (LEA) | 718 Seventh Ave. Sw, Albany, OR 97321 | 2018-10-25 |
| 1396232237 | Chiho Sakamoto Gunton | Social Worker | 227 Sw 3rd Avenue, Albany, OR 97321 | 2018-04-17 |
| 1700333184 | Albany General Hospital | Clinic/Center | 534 Pleasant View Way Nw, Suite 400, Albany, OR 97321 | 2016-09-02 |
| 1811373772 | Katrin M Ridge | Pharmacist | 1010 7th Ave. Sw., Albany, OR 97321 | 2015-08-03 |
| 1720485527 | Heartsong Counseling | Counselor | 425 Sw 2nd Ave. #203, Albany, OR 97321 | 2014-11-24 |
| 1619386604 | Courtney Ann Miller | Dentist | 2815 Willetta St, Suite A-1, Albany, OR 97321 | 2014-08-05 |
| 1346664810 | Jeffrey Othniel Nordtvedt | Case Manager/Care Coordinator | 2730 Sw Pacific Boulevard, Albany, OR 97321 | 2014-02-05 |
| 1174872022 | Albany General Hospital | Internal Medicine | 631 Southwest Elm Street, Suite 200, Albany, OR 97321 | 2012-09-06 |
| 1144594532 | Russell Travis | Pharmacist | 1177 Waverly Dr, Albany, OR 97321 | 2012-03-02 |
| Find all providers in zip 97321 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912521808 | Andrea Marie Pais | Dietitian, Registered | 113 Holland Ave # 120, Albany, NY 12208-3410 | 2020-06-05 |
| 1154944908 | Emily Macintosh | Dietitian, Registered | 43 New Scotland Ave # 35, Albany, NY 12208-3412 | 2020-05-27 |
| 1932728599 | Julie Clark Joiner | Dietitian, Registered | 425 W 3rd Ave Ste 350, Albany, GA 31701-1941 | 2020-04-14 |
| 1629553995 | Christine Marie Penicka | Dietitian, Registered | 391 Myrtle Ave Ste 3a, Albany, NY 12208-3797 | 2018-10-02 |
| 1023511649 | Courtney Lee | Dietitian, Registered | 30 Picotte Dr # E, Albany, NY 12208-1760 | 2018-03-09 |
| 1992227714 | St. Peter's Health Partners Medical Associates, P.C. | Dietitian, Registered | 319 South Manning Blvd Suite 307, Albany, NY 12208 | 2017-07-13 |
| 1235479387 | Albany Psychological Services for Eating Disorders, Pllc | Dietitian, Registered | 1 Pine West Plz Ste 106, Albany, NY 12205-5531 | 2013-02-27 |
| 1508139718 | Alison Marie Szczawinski | Dietitian, Registered | 20 Rose Ct, Albany, NY 12209-1317 | 2012-02-17 |
| 1376779405 | Regina Marie La Tourrette | Dietitian, Registered | 113 Holland Ave (120), Stratton Va Medical Center, Albany, NY 12208 | 2009-06-03 |
| 1548450810 | Patti Pinkerton Moon | Dietitian, Registered | 825 Evelyn Ave, Albany, CA 94706 | 2007-08-01 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.