JORDAN WILSON


Address: 2075 E Flamingo Rd -southmagna, Room242, Las Vegas, NV 89119-5188
Phone: 7025920069

JORDAN WILSON (NPI# 1962914341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962914341
Entity Type Individual
Full Name JORDAN WILSON
Practice Address 2075 E Flamingo Rd -southmagna, Room242
Las Vegas
NV 89119-5188
Mailing Address 6070 Burleson Ranch Rd
Las Vegas
NV 89131-3142
Practice Telephone 7025920069
Enumeration Date 2017-10-25
Last Update Date 2017-10-25
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered 39201-DI-0 NV Dietary & Nutritional Service Providers

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1710295951 Jordan Nicole Wilson Physical Therapy Assistant 111 E Washington St, Bensenville, IL 60106-2674 2010-09-22

Office Location

Street Address 2075 E FLAMINGO RD -SOUTHMAGNA, ROOM242
City LAS VEGAS
State NV
Zip Code 89119-5188

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780297077 Alexa Eisenberg Dietitian, Registered 4227 Pacifico Ln, Las Vegas, NV 89135-2525 2020-08-26
1881203552 Serena Marie Berman Dietitian, Registered 1810 E Sahara Ave Ste 122, Las Vegas, NV 89104-3707 2020-07-28
1689292054 Jessica Ann Galland Dietitian, Registered 1054 Dancing Vines Ave, Las Vegas, NV 89183-6320 2020-07-11
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1932738242 Nicole Caoile Dietitian, Registered 8352 W Warm Springs Rd Ste 300, Las Vegas, NV 89113-3631 2020-04-07
1104463124 Zenaida Huynh Dietitian, Registered 6888 Crimson Horse Ct, Las Vegas, NV 89148-5144 2019-12-09
1164082053 Mary Joy Inoceda De Guzman-walters Dietitian, Registered 11768 Via Esperanza Ave, Las Vegas, NV 89138 2019-06-13
1194382556 Marcelo Bellatti Dietitian, Registered 5600 Spring Mountain Rd Ste 106, Las Vegas, NV 89146-8822 2019-05-21
1538628672 Synergy Nutrition LLC Dietitian, Registered 3651 Lindell Rd Ste D263, Las Vegas, NV 89103-1254 2019-03-18
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Competitor

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City LAS VEGAS
Zip Code 89119

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Dataset Information

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.

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