Active NPI
Jerry Mayo, PHD, RDN
- Obesity and Weight Management Nutrition Registered Dietitian
- Conway, AR
National Provider Identifier
1083239115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity and Weight Management Nutrition Registered Dietitian
- Practice address
- 1060 Applewood Dr
Conway, AR 72034-3538 - Phone
- (501) 733-6575
- NPI assigned
- Jun 15, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | AR | Primary |
Addresses
Primary practice location
1060 Applewood Dr
Conway, AR 72034-3538
Mailing address
1060 Applewood Dr
Conway, AR 72034-3538
Phone (501) 733-6575
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jj@jmwellness.org | Direct |
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
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marjorie Nolan Cohn LLC | Past | Accepting new patients | |
| Fay Nutrition | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Registered Dietitian
- Conway, AR
- NPI 1235749359
-
- Registered Dietitian
- San Francisco, CA
- NPI 1104334465
-
- Registered Dietitian
- New York, NY
- NPI 1760825160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1083239115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 APPLEWOOD DR",
"city": "CONWAY",
"state": "AR",
"postal_code": "720343538",
"telephone_number": "501-733-6575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 APPLEWOOD DR",
"city": "CONWAY",
"state": "AR",
"postal_code": "720343538",
"telephone_number": "501-733-6575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYO",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "PHD, RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-15",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jj@jmwellness.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1060 Applewood Dr",
"city": "Conway",
"state": "AR",
"country_code": "US",
"postal_code": "720343538",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.