Active NPI
Jolene Kay Caldwell, RD
- Registered Dietitian
- Wynne, AR
National Provider Identifier
1063646867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- R491710
- Practice address
- 2005 Airpark Rd
Wynne, AR 72396-1806 - Phone
- (870) 238-4344
- Fax
- (870) 238-8937
- NPI assigned
- May 7, 2009
- Last updated
- May 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | R491710 | AR | Primary |
Addresses
Primary practice location
2005 Airpark Rd
Wynne, AR 72396-1806
Mailing address
2005 Airpark Rd
Wynne, AR 72396-1806
Phone (870) 238-4344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R491710 | Other | REGISTERED DIETITAIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R491710 | AR | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1063646867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 AIRPARK RD",
"city": "WYNNE",
"state": "AR",
"postal_code": "723961806",
"telephone_number": "870-238-4344",
"fax_number": "870-238-8937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 AIRPARK RD",
"city": "WYNNE",
"state": "AR",
"postal_code": "723961806",
"telephone_number": "870-238-4344",
"fax_number": "870-238-8937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDWELL",
"first_name": "JOLENE",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-07",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "R491710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DIETITAIN",
"identifier": "R491710",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wynne, AR
- Caldwell Discount Drug
- Caldwell Discount Drug Co Inc
- Caldwell Discount Drug Co., Inc. (Caldwell Discount Drug Co Inc, LTC)
- Caldwell Discount Drug Co., Inc. (Caldwell Discount Drug)
- Ashia Caldwell, MHPP
- Max A Caldwell
- Katherine Danielle Calhoun, RD, LD
- Callie Swaite, LLC
- Anita Carter, MHPP
- Charles Carter, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.