Jessica Grace Anderson, MS,RD,CSSD,LD,EPC
Individual provider Active NPI Nutritionist · Fort Bragg, NC
NPI 1053975987 · NPPES record last updated Mar 20, 2025
Key facts
- NPI
- 1053975987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- License
- L007668 (NC)
- Practice address
- 2817 Rock Merritt Ave
Womack Army Medical Center
Fort Bragg, NC 28310-5438 - Phone
- (910) 907-8116
- Fax
- (910) 907-6069
- NPI assigned
- Apr 25, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L007668 | NC | MD | Nutritionist |
| 08619 | OH | MD | Nutritionist |
| LD.08619 | OH | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 08619 | OH | |
| Registered Dietitian | 133V00000X | LD.08619 | OH | |
| Nutritionist | 133N00000X | L007668 | NC | Yes |
Addresses
Primary practice location
2817 Rock Merritt Ave
Womack Army Medical Center
Fort Bragg, NC 28310-5438
Mailing address
Womack Army Medical Center 2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8116
Other practice location 1
USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone (315) 772-1277
Other providers in Fort Bragg, NC
- Shelby Ammirati
- Zebediah Amparan
- Elizabeth Andersen
- Alfred Christian Anderson
- Jennifer Anderson
- Lisa Marie Anderson
- Patricia Elizabeth Anderson
- Stephen Anderson
- Steven Edward Anderson
- Robert Andrade
All providers in Fort Bragg, NC · Nutritionist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.