Individual provider Active NPI

Jordan McHenry, RD LD

  • Registered Dietitian
  • Plano, TX
National Provider Identifier
1003417437
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT87702 Issued in TX
Practice address
700 E Park Blvd Ste 206
Plano, TX 75074-5472
Phone
(972) 422-9180
NPI assigned
Nov 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT87702 TX Primary

Addresses

Primary practice location

700 E Park Blvd Ste 206
Plano, TX 75074-5472

Mailing address

700 E Park Blvd Ste 206
Plano, TX 75074-5472
Phone (972) 422-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711000157 TX Practitioner - Registered Dietitian Or Nutrition Professional 0749691095 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nutriphasics, LLC Dietitian, Registered CurrentSince May 9, 2022 Accepting new patients
Nourish, Inc. Dietitian, Registered CurrentSince Feb 9, 2024 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

250 Fillmore St
Unit 150
Denver, CO 80206
Phone (410) 505-0521

525 N Tryon St
Ste 1600
Charlotte, NC 28202
Phone (855) 478-8208

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

10260 SW Greenburg Rd
Fl 44
Portland, OR 97223

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

400 Chisholm Pl
Ste 100
Plano, TX 75075
Phone (888) 422-8070

700 E Park Blvd
Ste 206
Plano, TX 75074
Phone (469) 564-4211

Networks

  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • TX HMO
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • TX HMO D-SNP
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1003417437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E PARK BLVD STE 206",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745472",
            "telephone_number": "972-422-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E PARK BLVD STE 206",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745472",
            "telephone_number": "972-422-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHENRY",
        "first_name": "JORDAN",
        "credential": "RD LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-09-21",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT87702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.